Tightness of the Upper Spine and Running Performance

Good mobility through our thoracic spine (upper back) is vital for good spine health. However, the thoracic spine is inherently stiff due to bony anatomy of the spine itself. The ribs, which serves to protect our heart and lungs, also limit thoracic spine mobility. Poor posture and prolong sitting are the typical causes of tightness in the thoracic spine. In my case (and all moms),  the increase demand of caring for JuJu has significantly increase the stiffness of my thoracic spine extremely.

My upper back flexed to play with JuJu.

What does it mean?

Stiffness in the thoracic spine can cause low back, neck and shoulder pain. Limited motion in the thoracic spine forces the adjacent joints to compensate. These joints move more in order to make up for the lack of motion. This can lead to numerous injuries ( we can save this for another post).

In runners, a tight thoracic spine can hinder taking a proper breath and loading the core.
Typically the thoracic spine is stuck in a forward position ( mostly form sitting all day) which limits the body from sitting in a proper upright posture. Proper posture allows the body to take a full inhalation. Try sitting slouched and taking a deep breathe. Now, sit up straight and take a deep breathe. Notice the difference between the two. Being in a slouched position while running will limit your ability to inhale which hinders performance.

L: Pre mobilizations in below video- It was more difficult turning with my upper back. More of my sports bra can be seen. It's also harder to turn my neck. R: Post mobilizations in below video- There is improve mobility in the thoracic spine. My spine is turned making it more difficult to see the back of my sports bra. It is also easier to turn my head.
***BONUS- Look at my left foot. In the left picture it is more flat. In the right picture there is a greater arch. Being able to rotate through the spine helps to transmit forces into the foot to support the arch. 

Having proper rotational mobility also helps to load the core. The arm swings backwards as the leg drives forward. A rotational stretch is then placed on the core. This stretch helps to provide energy to the opposite leg to help drive it forward. When the core is not properly loaded, it places an extra rotational stress to the low back leading to pain. Poor loading of the core can also lead to improper running mechanics contributing to different injuries throughout the body.

The Science

The spine has motions which are coupled. When the spine is straight, side bending one direction will cause a rotation to the same side ( Type 2 motion). When the spine is extended, side bending one direction will cause a rotation to the opposite side (Type 1). These movements are hardly noticeable  but necessary for proper mechanics. In running type 2 motion occurs. When you are landing on your left leg, gravity pushes down on the right shoulder. This will cause your head to be tilted. To get your head pointed straight, your body will have a slight lean to the left.  Side note-When the glutes are weak causing an extreme pelvic drop, the spine has to excessively lean to compensate which leads to injury.

When gravity pushes on the R shoulder
L: Shows the spine without a lean
R: Shows the spine with a lean 

At the same time, the right arm  swings forward to generate a left rotation. The left lean of the spine  and the right arm drive to the left causes a type 2 motion of the spine. Where you place your legs is also important. Mobilizations in a staggered stance verses a squat stance most replicates how the body is moving while running. When the right leg is forward, the right arm swings backwards while the left arm swings forward. The arms are used to drive rotation in the thoracic spine.

Mobilization

One of the exercises to loosen up the thoracic spine is to foam roll. However, this only mobilizes the joint in one dimension. Imagine a drawer which is stuck. Do you keep pulling it straight out or do you wiggle it all directions until the drawer opens. I don't know about you but the later has worked for me.
At 3DRunner we're going to mobilize the thoracic spine functionally in all 3 planes of motion.

Since the arm swing generates a rotation in the spine I decided to check rotational range of motion.
As you can see with my left hip forward, I have slightly less rotation. After the mobilizations, my spine has increase mobility.

Type 2 motion Stand with the right leg forward and left arm next to your ear. Use your right arm to swing backwards. The backwards arm swing will gently mobilize your spine. Try swinging at different angles. Keep the same posture, right arm slightly behind, reach left arm upward towards the ceiling.
Type 1 motion Stand with the left leg forward and left arm next to your ear. Use your right arm to reach forward. With this mobilization, it is more effective to reach as oppose to swing. Reach at different angles. Keep the same posture, right arm forward, reach left arm upwards towards the ceiling

Perform 10-20 of each then switch sides ( right leg forward, right arm next to ear and left leg forward. right arm next to ear)

Mobilizations for the thoracic spine will improve your posture resulting in better core recruitment and breathing to enhance running performance. Improve mobility will promote proper running mechanics to decrease injuries.

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It's Plantar Fasciitis!

You get out of bed one morning and your foot hits the ground. "OUCH!" What's causing this pain? You walk around getting ready for work and the pain seems to be disappearing. "Phew", you have to go for your 10 miler after work. The next day the same thing happens. Eventually, you feel the pain every time you stand. AND even when you are running! Finally, after a week you decided to do a Google search - plantar faciitis.
You roll, you ice, you wear a sock thing at night, but nothing changes.

What is plantar fasciitis?

Plantar Fascitis is the inflammation of the fascia (connective tissue) on the bottom of your foot. It spans from the heel to the toes. At the beginning stages,  the tissue gets stretched with weight bearing however over time, with each step the tissue gets more inflamed.

What are the risk factors plantar fasciitis?

A systematic review of journal articles on plantar fasciitis was performed in 2008 and revised in 2014. The big risk factors for getting plantar fasciitis are being a runner, a person who stands for work and limited ankle dorsiflexion. We all all know you're not going to stop running or working, so let's focus on what we can change.

Limited ankle dorsiflexion
This means the ankle joint has a limited mobility to flex the foot towards the body. Ankle dorsiflexion is required to have proper mechanics while running. When ankle dorsiflexion is limited, the sequence of movement of the foot is changed, putting more stress onto the plantar fascia.
Tightness of the calf muscles ( gastrocnemius and soleus) can also contribute to limited dorsiflexion. Connective tissue from the calf spans down into the heel and blends into the plantar fascia. Limited mobility of the calf muscles can contribute to increase stress of the plantar fascia.

Treatment

Ball Roll on Calf 

Most people with plantar fasciitis know to roll the bottom of their foot on a tennis ball or golf ball. However, there is a myofascial pain referral zone at the base of the calf where the muscle becomes tendon. This zone is slightly to the outside of the center of the muscle tendon junction. In a long sit position, use a roller or a lacrosse ball to roll out the area for 2-5 minutes depending on tolerance.

'X' marks the spot

Ankle Mobilization

Lace Lock method

When you can't have a therapist to follow you around, you have to improvise. Using a running shoe is the perfect substitute to assist in self mobilizations. Tie shoes using the lace lock method. Thread the lace on the same side through the last hole. Pull the opposite lace through the hoop. Tie the shoes really tight across the front of the ankle. In standing, put one foot in front and rock forward allowing the knee to bend to mobilize the ankle. Angle the knee to go over the pinky toe. Then angle the one to go over the big toe.
5 times each direction
*** Only tie the shoes laces very tight when mobilizing!!

Calf Stretch with Tri- Plane Tweak

This is a tri-planar tweak on the standard calf stretch. Stand with one foot forward and use knee to drive the motion forward. Then twist left and right. Lastly sway your hips side to side.
Perform 10-15 repetitions

Out of the box

In normal mechanics, the hip and thoracic spine absorbs lateral and rotation motion respectively as the arms swing back and forth. However, if those regions are stiff, the motion is transferred to the ankle. The ankle is forced into an over supinated position. In the supinated position the foot is unable to absorb shock putting more stress on the plantar fascia. Improving mobility in the hips and thoracic spine will take the stress off the plantar fascia.
Please refer to earlier post on stretching the hip and thoracic spine.

http://3drunner.blogspot.com/2015/03/spine-stiffness.html
http://3drunner.blogspot.com/2014/06/ankle-sprain-how-thoracic-spine-and-hip.html

By addressing limitations locally in the ankle and globally at the hip and thoracic spine, you achieve a more comprehensive treatment plan.

Don't be the Hunchback Runner- How to Mobilize the Thoracic Spine

The hip flexors have been getting the spotlight as the evil which contributes to injury. However, the THORACIC SPINE also has a significant influence on injury. The thoracic spine is the area between our shoulder blades. It has a tendency to be stiff because gravity works against our bodies pushing down on our shoulders. Gravity pushes our body down at the shoulder which flexes the thoracic spine. After hours of sitting letting gravity take it's toll, the upper back region stiffens. Think of a hunchback. A flexed thoracic spine limits our ability to stand up straight. Stiffness of the thoracic spine can contribute to injury to the neck, shoulders and low back.

Before and After

Before and After

The pictures above show the side view of the back before and after stretching. There is increased curvature at the base of the neck and the low back.  After stretching, his neck and low back is in a better alignment. Also, there is an improved ability to raise the shoulder. This shows how tightness in the thoracic spine can influence other regions of the body.

While running, the arm swings backward causing a rotation to occur in the thoracic spine. Meanwhile, the same side leg swings forward. The twist of the spine helps to load the core, think of twisting a slinky. However, if the thoracic spine is stiff the low back takes the load. The most frequently injured and degenerated region of the spine is the L5 - S1 (lower back region). Not surprising, this is also the region of the lower back which has the ability to twist the most.

The thoracic spine supports the lower back, and  its bony anatomy allows for rotational movement. However, if the area is stiff, motion is mainly absorbed in L5-S1 leading to overuse injury.
In running, a stiff thoracic spine contributes to injuries of the low back. The overly flexed thoracic spine can limit rib expansion, hinder breathing and limit loading to the core.

Exercises

On top of using a foam roller or lacrosse balls to help loosen up the spine, there are stretches which help mobilize and utilize the muscles.

Use a foam roller across the back between the shoulder blades
 and roll up and down for 2-3 mins

Use a lacrosse ball in the front part of the
chest and move side to side and up
and down for 2-3 minutes

Mobilizations of the Thoracic Spine

Below is a video how how to use arm movements and pelvic motions to mobilize the thoracic spine. These exercises will help increase rotational motion of the thoracic spine allowing increase loading to the core and decrease strain to the lumbar spine. 

I like to follow up mobilizations with strengthening exercises to train the new motion. Please refer the the strength post for ideas on how to train the thoracic spine.

http://3drunner.blogspot.com/2014/07/3d-strength-for-runners.html

These mobilizations will not only enhance mobility for runners but is great for any athlete.

Thanks to Gary Gray at the Gray Institute for the remarkable knowledge.

Are you READY TO RUN?

Ready to Run was released in October 2014, and is designed to help runners recover from injury. This book is written by the same author who wrote "How to Become a Supple Leopard," physical therapist and co-founder of San Francisco Crossfit, Kelly Starrett.

"Ready to Run in organized into 3 main sections: the introduction, the 12 standards, and mobilizations. 

Below are the 12 standards which are assessed in order to be "Ready to Run".

1) Neutral Feet

2) Flat Shoes

3) A Supple Spine

4) An Efficient Squatting Technique

5) Hip Flexion

6) Hip Extension

7) Ankle Range of Motion
8) Warming up and Cooling Down

9) Compression

10) No Hotspots

11) Hydration

12) Jumping and Landing

Starrett goes thoroughly details each of the standards by explaining what it means, why it is important and how to fix it. Each standard has a "Runner to Runner" section which is a story related to the topic written by co-author T.J. Murphy. If appropriate, he recommends mobilizations for each of the standards. The mobilizations are strategies on how to improve mobility of the region, and are detailed at the end of the book.

So does Ready to Run really get you running ready?

I allotted myself 3 weeks to work the recommended mobilizations to help achieve Starrett's 12 standards. Below is a sampling of my results. The pictures on the left were taken at the beginning of the 3 weeks, while the pictures on the right were taken after the mobilizations were performed.

Posture - Front view

Posture- Side view

After performing thoracic mobilizations and pectorals soft tissue work, my posture has significantly improved. My back is straighter, my neck is over my body and my shoulders are pulled back. This helps to reduce the stress on the low back, neck and shoulder.

Hip Flexion

I am able to lift my leg higher and with less struggle. In the pre picture my trunk is rounded forward while in the post picture I maintained an upright position. 

Hip Extension

There is more hip extension in the post picture. Hip extension allows better recruitment of the gluteals and decreases stress to the lumbar spine.

Squat Position - Front view

Squat Position - Side view

There is significant change in the pre and post squat position. I am able to get lower and keep my back straighter in the post pictures. In the side view of the pre picture, you can see the stress in my neck from the crinkling in my skin. Also, in the pre picture you can also see the change in the curvature of my lower back.

In addition, I also worked on the other standards by wearing my compression socks, using the compression band ( please see http://3drunner.blogspot.com/2014/08/compression-band-for-lower-extremity.html) and staying hydrated.

Pros

Ready to Run is a great tool not only for runners, but for just about anyone who is looking to improve their mobility. The book is chalked full of information on injuries, mobility and self mobilization techniques.

Born to Run also does a good job instructing readers on how to perform basic mobilization techniques, and helps you take charge of improving your mobility.

Finally, Starrett also does a good job covering other contributing factors such as shoes, compression garments and hydration.

Cons

Ready to Run presents a lot of techniques, and due to the organization of the book it can be difficult to deduce what injuries are related to what specific limitations. As a result, you may end up performing all the mobilizations in the book (which is not necessarily a bad thing, it just takes awhile).

While the mobilization techniques are nicely organized with their own appropriately titled chapter in the back of the book, compression techniques are found within the standards section titled "No Hotspots." This can make the compression techniques a little difficult to find, especially if reading the text as reference material.

Decision

I think Ready to Run is a great tool for beginners and veterans alike. If you would like to learn self treatment techniques in order to minimize and prevent injury then check out Ready to Run.

I Have Sciatica, Why Are You Grabbing My Foot?

It is 5 am in Badwater, CA. There are approximately 100 runners toeing the chalked line. There is 135 miles, over 10,000 ft in elevation gain and 120 degree heat under the Death Valley sun between them and the finish line. I see my runner crossing the horizon towards our support car, his stride looks shortened, but smooth for mile 60. Over the next 75 miles we take turns passing off race essentials. At 4 am, as a team, we cross the finish line at Whitney Portal.

So how did this journey begin?

From the moment I met him I could hear the “thud”. It was the sound that his foot made as it he walked through the clinic.  He tells me he is a runner, but not just a runner, but he is running in the Badwater Ultramarathon in July. 135 miles of “thudding” into the ground! To bring the pressure up a notch, this is going to be his 11th consecutive finish. As I watched him move and walk, I can't stop focusing on the stiffness of his foot which is causing the "thud". But how do I explain his lack of foot mobility is contributing to what he is actually coming to see me for… SCIATICA?

What is Sciatica?

Sciatica is a general term used to describe inflammation of the sciatic nerve or nerve roots which comprise it. Sciatica can be caused by a disc injury or stenosis (narrowing of spaces of the spine), which puts pressure on the nerve roots. When our foot hits the ground force is transferred up the leg and into our lower back. Our foot is designed to pronate upon impact to allow for shock absorption.  The bony anatomy of our foot and ankle causes a biomechanical chain reaction. This generates a rotation in the leg then into the pelvis which helps to recruit the gluteals to provide the stability of the back. However, if the foot remains supinated, ground reaction force is transferred into the spine instead of being absorbed through the foot and leg. When the mobility of the foot is limited, the lower back is forced to move more to compensate for the lack of motion. The increase motion of the back decreases the amount of space the nerve has to pass through the spine.

When the foot pronates it causes a rotation up the leg which
helps to dissipate force and maintain good motion of the back.

When the foot remains supinated the foot remains rigid forcing
the back to rotate more which decreases space for the nerves.

To improve his foot mobility I begin to facilitate pronation of his foot. IT worked! His sciatic pain decreased.  I worked on it some more and his pain was gone! He was able to walk and jog in the clinic without his symptoms. 

From the moment I helped his foot become more supple and pronate, his sciatic pain got better.

So when you foot hits the ground: is it supple (pronated) or rigid (supinated)?

             

You can even see from the pictures above the difference in the position of the pelvis.

Techniques

Mobility

The technique is performed to increase mobility of the foot to reduce stress to the lumbar spine. This will help minimize your risk of sciatica. Stenosis is narrowing of the canal in which the nerves exit the spine. If you have a herniated disc, this is NOT a technique for you.

For forefoot runners, it is also important to have a mobile foot. The motion of supination and pronation occurs in the forefoot instead of the mid and rear foot.

Strengthening
After mobilizing the foot, it is important to retrain the muscles and joints in this new motion. This allows the newly acquired motion to be recognized as a movement path. If your body doesn't use this motion, the foot and ankle will become stiff again.

Here are examples of exercises which use the muscles and joints in all 3 planes of motion to retrain the body.

Please consult with a health care professional prior to performing these exercises. If it increases your pain, STOP!

Compression Band for Plantar Fasciitis, Ankle Sprains and Knee Pain

At the request from multiple people, this post is focused on how to use a compression band (voodoo band) for the lower extremity. The feedback I receive after being wrapped is the treatment area feels lighter, more mobile and less achy. This is does not fix an injury but a way to manage your symptoms.

On the left is a home-made compression band from a bike tube.
On the right, is the compression band aka. voodoo band

How the compression band works

The band works by providing a compression onto the connective tissue. Imagine our connective tissue as a kitchen sponge. When it is being used, the sponge soaks up dirt and grime. When the sponge is compressed the dirty fluid is squeezed out and upon release fresh water is absorbed. By pushing stagnant fluid out and allowing fresh fluid to enter, our soft tissue is lubricated and mobility is restored! Drink Water!

How to use the compression band

Stretch the band about 50-75% and cover half of the prior band. I recommend performing stepping motions in all 3 planes of motion to maximally compress the different aspects of the connective tissue. The band stays on for no more then 2 minutes maximum!


DO NOT use the band if you have peripheral vascular disease, peripheral neuropathy or being treated for cancer. Take the compression band off if the tissue becomes gray, have numbness and tingling or have sudden claustrophobia

The band can be purchased online or you can cut a bike tube in half and split down the middle for a flat band. Note: A bike tube is much shorter then the 7-foot band and you'll smell like rubber.

I will demonstrate on to use the band for the lower extremity - foot, ankle and knee. 
The band can help reduce symptoms associated with plantar fascia, ankle sprains, Achilles tendonitis and general knee pain. 

Plantar Fasciitis 

Start the wrap at the base of your toes and wrap around the foot and onto the ankle. Tuck the end in. You can perform toe curls and extensions, ankle pumps and ankle circles. For the best effect perform a lunge matrix. 

Ankle Sprains and Pain

For ankle sprains, start the band the base of the ankle. Always start the band distal to the ankle to push the swelling into the leg to be absorbed. You want to cover the skin as much as you can so the swelling doesn't get pushed into the uncompressed area. Covering the entire surface around the ankle can be tricky. I recommend completely covering the heel with one circle and angling the ankle down.

This method can also be used for Achilles tendonitis.

Knee pain 

Start the band below the kneecap. You should have enough the cover the entire knee. Tuck the end of the band under the. You can bend and straighten your knee at different angles or contract your quadriceps muscles. My recommendation...  a lunge matrix!

The band can also be used around your muscles such as quadriceps and calf. 

Please see your MD if your pain is a chronic or serious injury.

Those who have use this please comment and give your feedback!

#compressionband #voodooband #kneepain #anklesprain #achillestendonitis #plantarfasciitis # pain 

So Why Can’t We Recruit our Glutes?

Recently, I have noticed an increase in discussion on how weak gluteals are linked to numerous injuries. Injuries such as hamstring strain, knee pain, and low back pain can all be traced back to weak gluteals. We diligently stretch and strengthen but we all still seem to have difficulty activating our gluteals…WHY? Well here are some reasons:

We sit a lot!

Nearly all of our daily activities are performed in seated position. From eating a meal, driving, sitting at a desk at work, to relaxing on the couch; the majority of day is spent sitting. Additionally, we don’t always sit up straight. We lean against the couch end, we scrunch up in an airplane seat, or we squint at our computer screen, all of which leads to imbalances in our body. From prolonged sitting, the soft tissue in our glutes becomes desiccated and stagnant making it difficult to recruit and generate force. Furthermore, the tightness in our hip flexors also contributes to greater difficulty recruiting our glutes.

In a typical workday, an office worker can sit upwards of 14 hours! Does 10, 20, or even 30 minutes of stretching and strengthening our hips and glutes make a difference? It depends! If a person’s goal is to walk without pain, 20 minutes of exercise may help. BUT if a person’s goal is to return to running a marathon, 30 minutes worth of stretching and strengthening will likely not cut it.

Here’s a video on how to lacrosse roll glutes – One way to restore the soft tissue is to roll it out. By applying pressure on the muscle it pushes the stagnant fluid out and upon release new fluid is allowed in. The process is similar to how a kitchen sponge works.  

Bonus Videos on hamstring!

Is All Pelvic Drop Really Bad?

When standing on one leg study your hip alignment in a mirror. When you lift one leg the pelvis drops on the opposite side, it is an indicator of a weak gluteal in the standing leg. This is called a pelvic drop. There is discussion that the pelvis must stay level in order to obtain proper running form because it’s a sign of a strong glute. Current consensus states that allowing the pelvis to drop can lead to bursitis, ITB syndrome, and knee pain. However, in order to properly load the glutes, the femur must be able flex, adduct and internally rotate relative to the pelvis. Allowing the pelvis to drop (hip to adduct) will actually recruit the glutes. The glutes’ ability to decelerate tri-plane motion is what actually helps keep us injury-free.

Recent biomechanical research agrees that some amount of hip drop is acceptable. If one of those movements is lacking it can place extra stress onto other motions.

The pictures on the left (top to bottom) show the difference in pelvic drop on the right leg (4 degrees) compared to left leg (8 degrees), prior to tri-planar stretching and still with symptoms. The pictures on the right show demonstrate an equal pelvic drop achieved from tri-planar stretching. This results in the ability to run with minimal to no pain.

My example- I had a slip and fall injury which took over 4 years to recover from. I saw numerous MDs, had countless MRIs (often hoping for a positive result, but always coming back negative) and several injections without any relief. It was noted by fellow professionals that I had opposite hip pelvic drop, so I took up a regimen of traditional hip exercises (clams, bridges, etc.) with minimal change. I decided to look at my own videos and concluded that my injured hip did not have ENOUGH pelvic drop. Since I started working on hip mobility I have been able to return to running with minimal symptoms.

So listen to your patient or client and screen the whole body in a kinetic chain and in all planes of motion.

Do Clam Shells Really Get You Back To Running

      Maybe? Traditional gluteal strengthening exercises such as clams, hip bridges, leg lifts and planks provide a good foundation. However, in order to function you must perform exercises that replicate the motion you are trying to fix. The traditional exercises are not authentic to the movement of running. Performing functional exercises in an upright position are necessary to return to functional strength.  While basic strength exercises are necessary for a strong foundation, functional exercises are equally, if not more, important because it resembles our activity, RUNNING. After a long day of sitting, performing activation exercises prior to your run helps to stimulate the muscles. Running requires impact, impact which can injure if our muscles aren’t ready to take it. Think of activation exercises as something to get the rust knocked off of your shock absorbers to prepare the muscles functionally for the impact of running. To help recruit your gluteals while running, when your foot hit the ground kick the leg back and slightly outwards. Perform this activation exercise during the first couple minutes of running to stimulate the glutes.                          

Clam exercise - does it resemble running?

Lunge with reach - resembles running!

Please refer to the post on strength for functional exercises.

PLAN

 1)   Lacrosse ball roll glutes or any other body part. My pre-workout routine is roll out hip flexors, upper back and glutes. I also roll my calfs and quadriceps if they feel tight.

 2)  Make sure your motion in all three planes is adequate on both sides. Stretching my left hip allows my RIGHT hip to go into the frontal plane!

 3)  Perform not only basic glute exercises but functional exercises to gain a good foundation and tri-plane strength. Do activation exercises prior to your run!

ANKLE SPRAIN - How the Thoracic Spine and Hip Can Contribute

Recovering from an ankle sprain appears to be pretty straight forward, however there are other factors which can hinder recovery. The two areas we will focus on are the hip and thoracic spine (upper back). Daily activities in the sitting position, such as computer use, reading and driving, etc., results in an increase stiffness in our hips and thoracic spine.
The tissue surrounding the gluteals become stagnant from prolong sitting making it difficult to generate force and absorb energy. At the same time, the hip flexors in the front of our pelvis shorten from sitting.
The thoracic spine is another region which is affected from prolonged sitting. The muscles of the thoracic spine work to fight gravity which pulls our trunk forward. Most daily activities which are performed in front of our body also contributes to increase pull forward.  To make matters worse, the thoracic spine is a difficult area to stretch due to the bony anatomy and rib cage.
Limited mobility of the hip and thoracic spine changes our biomechanics which can impair the body's ability to recover from a lateral ankle sprain.

HIP

Hip Mobility

When the heel hits the ground, the bony anatomy of the ankle generates a rotational force up the lower leg and into the thigh. At the same time, the body weight shifts from the back leg to the lead leg which produces a lateral motion of the hip and pelvic junction.

If there is a limitation of frontal plane motion of the hip, the movement will find another path. A common pathway is the ankle.  As the body shifts laterally to the front leg with a limited hip motion, the lateral movement will be forced at the ankle causing a lateral ankle sprain.

Hip Mobility Assessment

Stand with your legs hip width apart. Bring your arms up next to your head. Reach to the side as far as you can, then to the other side. Feel for any difference in motion in your hips from side to side. You may need to stand in front of a mirror or have a friend to give you feedback.

The above pictures show less mobility on the left hip (picture on the right). The larger hip/pelvis angle reveals there less motion occurring at that joint. Side note: I roll my left ankle during this run.

Hip mobility Treatment

Lateral hip stretch -

To stretch the side of the hip, stand next to a low bench or step. Place the leg across body onto the step with the knee bent. Allow the body to move over the stance hip until you feel a stretch. Use your pelvis to drive forward, sideways and twist. Please refer to the video above.


***Bonus lateral hip stretch - Instead of crossing the leg in the front, cross my leg behind my body.  Make sure the back leg does not twist the body away from the stance leg. Shift toward the stance leg. Then use the pelvis to drive the body in the sagittal plane, frontal plane and transverse plane. Please refer to the video below.

Gluteal Stretch -

Place one leg on a table ( at home I use the end of my couch, kitchen or bathroom counter) at about mid thigh to hip height depending on flexibility. The knee should be bent to 90 degrees and thigh perpendicular to body. From there, hinge forward in the sagittal plane, reach away sideways in the frontal plane and rotate towards in the transverse plane to the stretch leg. These motions create length at the hip and pelvic junction. Perform about 10 repetitions per plane of motion or until you feel improvement in flexibility.
Refer to the video above for planes of motion.
*** Hinge at the hip NOT the lumbar spine.

THORACIC SPINE

Thoracic Spine Mobility

When one leg is swinging forward, the same side arm is swinging back. The swinging of the arm backwards drives rotation of the upper back. For example, as the right leg swings forward the right arm swings backwards. A rotational motion is created at the core since the opposite leg is behind the body. This position helps to load the abdominals in a rotatory fashion, similar to a spring.
If the thoracic spine is tight, the rotation will bypass the region and the motion in transferred elsewhere. Occasionally, this force causes a shearing motion in the back. Other times, the force goes into the ankle.

Thoracic Spine Assessment

Place one leg in front of the other with the knee slightly bent. Bring your arms in front of your body at chest level. Turn as far as you can towards the front leg then towards the back leg. Switch so the other leg is forward. Feel for the rotation in the thoracic or have a friend watch for you.
Watch the video below.

 

Thoracic spine treatment

Rotation T/S stretches- These stretches improve the rotation of the spine.

To improve rotation of the thoracic spine while the arm is swinging forward - Take a step forward with L leg and L arm next to head, bring R arm in front of body and reach forward. 
To improve rotation of the thoracic spine when the arm is swinging backwards - With L leg in front and R arm next to head, swing L arm behind the body.
Refer to the video below.

To maximize the effects of the stretches, follow up with strengthening exercises. Performing strengthening exercises after stretching will stimulate sensors in the newly acquired range of motion which may have been dormant for weeks, months or years.

Stay tuned for my next post on strengthening exercises for runners!