Improving Hip Mobility using Strength

Stretching is overrated! There I said it!
Stretching helps to improve muscle length but most runners are looking to loosen up muscles by helping muscle fibers glide better. This is accomplished through rolling. If you are generally a stiff person by all means, stretch. BUT, if you're an athlete or a runner who had a muscle or a joint suddenly tighten up on you, you can probably benefit from strengthening. Strengthening will provide stability to the region which allow the muscles and connective tissue to relax.

In the past several days I noticed my right hip is acting up again only when I carry JuJu (14lbs) in her Ergobaby. Mostly, my hip feels sore and stiff. I figure once I return to a consistent core workout routine the hip tightness will go away. Side note- I have a tendency to skip my core exercises as my run milage goes up. The next day while I was rocking JuJu to sleep, I notice my right hip wasn't moving. My right hip felt stuck when I moved side to side with my feet turned out.

Why it's important for running?

When the leg lands on the ground a load is place upon it. Your body weight shifts slightly over that leg and rotates over it. The rotation in the hip is internal rotation. Ok, so why is external rotation important? External rotation is needed to internally rotate. Put your hand on a table and lift one finger up and let it hit the table. Now, use the other hand to lift one finger and let it hit the table. Notice the difference in power. The opposite motion in needed to generate power in the direction you want.

Stability is a key factor in how loose or tight a joint or muscle is. Strong muscles provide stability to joints and surrounding tissue. Weak or inhibited muscles do not provide enough stability to the region and the body will reflexively tighten to provide stability.

In my case, external rotation was limited which  most people would stretch. Since I want to strengthen my muscles I decided perform strengthening in the opposite direction of the limitation, internal rotation. The improve mobility may be an affect of autogenic inhibition. Autogenic inhibition is when the sensors in a muscle are activated during a high stress load to shut down the muscle. It is  a protective mechanism to avoid tearing a muscle. In my case, activating the muscle will trigger it's relaxation. Strengthening in the opposite direction helps re-train proprioceptors of the muscles to work in a greater range of motion allowing for improve stability.

Exercises

Here are a few exercises I performed accentuating internal rotation of the hip. The end of the video shows my hip mobility post exercises. The above video ( purple tank) was filmed earlier in the day. There is a big change in right hip range of motion.



Forward lunges with rotation - Lunge forward and use your arms to rotate the body towards the front leg. This places the front hip in internal rotation.

Side lunges with internal rotation - Perform a lateral lunge with foot pointed in. This will also create an internal rotation at the hip. For greater internal rotation, reach your arms toward the leg.

Cross body lunge - As you lunge forward turn your hips inward. This will create an internal rotate of both hips. This is the best exercise for runners as it most replicates what the hips do in running.

Perform 2-3 sets of 8-10 reps

So when you feel like your muscles are tight and stretching isn't helping, try performing strengthening exercises. Stretching is a short term solution to a long term problem. Strengthening is a key component to keep muscles relaxed.

Glutes - How to Transition From Exercise to Run

You've been told you have weak glutes. Whether it's hip pain, knee pain, ankle pain, it all can be "healed" by improving glute strength. You are prescribed clams, side lying leg lifts, bridges then progressed to squats and lunges. You feel stronger and released to go for a run. Your symptoms feel better but returns after getting back to your routine.

Recruiting Glutes vs. Quads

Is your strength transferring from a basic clam exercise to running? Are your glutes REALLY activating when you run? For most of us, we are very quad dominant. This means we over use our quadriceps when we should be using other muscles such as our glutes. Our sedentary lifestyle of sitting at work or relaxing on the couch has us disengaging our glutes. The quads have at a mechanical advantage to work. Also, the habitual use of quadriceps enhances the neural input from the brain is going to the quads and not the glutes. In other words, the wiring to the quads is better then wiring to the glutes. When running, demand on the muscles is so high we use whatever muscles are the easiest to recruit. The Quads.

I have seen and used different cues such as "stick out your butt"or"squeeze your butt as you stand up". However, most of my patients and clients have a difficulty "feeling the exercise". AND, the improved strength doesn't seem to translate to running.

PUSH YOUR KNEES BACK

I have been using a different cue to activate the glutes while performing standing exercises such as squats and lunges. While you are performing squats or lunges (or any standing hip exercises i.e. box step ups), pretend like there is an object behind your knee and push back as you stand up. The gluteus maximus is responsible for hip extension, getting your thigh behind you body. However when your foot is fixed on the ground and the knee is given the cue to push back, this extends the knee AND hip. This will engage your gluteus maximus.




Stand up and perform a squat. When you stand up, you feel your thighs press down into the ground and push up. Now try a squat but give the cue for your knees to push back.

FEEL the burn in your glutes.

Now, think of this cue when running. You want to let your knee land normally (with a soft bend), then push back with the knee as your body is moving over your leg. You should feel like your legs are moving in a circle, almost like pedaling a bike. At first, I recommend incorporating this during a warming up, then into sides and finally into your short normal runs. The best way to feel this is up hill sprints!
THIS CUE WORKS BEST IF YOU MIDFOOT OR FOREFOOT STRIKE!

So on top of performing clams, leg lifts and squats add this "push your knee back" cue to the standing exercises.

Please contact me if you have any questions or concerns.

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!

3D Strength for Runners

As runners we are great at moving our body forward in the sagittal plane over LONG periods of time. On top of that, most of us strengthen by performing squats, lunges, bench press, etc. which promotes mostly the sagittal plane of motion. What we don't realize is how much side bending (frontal plane) and rotation (transverse plane) our body goes through while running.

Here is a series of exercises which focus on the frontal and transverse planes of motion we use while running. These exercises have a foundation based on lunges and squats by using our arms to drive motion in other planes of motion. Using our arms as a driver also strengthens the core and upper extremity.

These exercises can be performed prior to a run ( after stretching) for muscular activation. When performed prior to a run, do not use any weights. For strengthening use between 5 - 10 lbs., depending on the exercise. This helps to build muscles in all three planes of motion.

In addition to tri- plane exercises, I perform more traditional strengthening exercises such as squats ( 135 lbs!!), pull ups, power cleans and dead lifts. However, lack of strength and endurance of muscles which control the accessory motions (frontal and transverse plane) contributes to fatigue leading to injuries. Adding tri plane exercises to your strength routine will help reduce fatigue, and as a result, decrease your susceptibility to injury.


These are basic tri-plane exercises but can be made more complex as the athlete becomes familiar with the techniques.  



I perform 10 repetitions, typically 3 rounds using 5- 10 lbs.

FORWARD LUNGE WITH OVERHEAD REACH

Yes, this exercise is done in the sagittal plane. However, this exercise is powerful because bringing our arms overhead enhances extension of the core muscles. Lifting our arms overhead also creates an eccentric load through our abdominals which is how it contract while running.  

Take a step forward while bringing both arms overhead. This creates extension through the trunk and the hip flexors. To make the exercise more similar the running, bring the same arm overhead as the leg stepping forward ( as shown in the front view). Bringing the same arm overhead will help create a rotational movement in the upper body similar to the arm swinging back.

SIDE LUNGE WITH SIDE REACH

This exercise helps to promote the frontal plane motion which occurs while running. As the leg swings forward our body weight shifts laterally over the front leg. Bringing the arm out to the side drives a rotational motion in the thorax eccentrically loading the abdominals. 

Take a side step while bringing the same side arm to the out and behind. ( similar to a throwing motion). Focus on sitting back through the glutes, having your torso shift over your knee and keeping your foot facing forward.

BACKWARDS CROSSOVER LUNGE AND CROSS REACH

This backwards lunge helps to promote gluteal activation in the frontal plane while using the arm to drive upper torso rotation. 

Reach backwards and across the stance leg while reaching the same side hand in front of the forward leg.

SPLIT SQUAT WITH CROSS BODY ARM SWING

This exercise focuses on rotation of the trunk and loading the hip in a transverse plane of motion. 

Place one leg in front and as you squat down swing the same side arm behind, As you come up swing the arm cross body. Stop the motion with the other hand.

FORWARD LUNGE WITH CROSS BODY REACH

This lunge helps to generate the transverse motion of the core and glutes using the opposite arm as the driver.

As you lunge forward reach opposite arm in front of the knee. As you step back bring arm up and out to the side.

To increase the challenge as you step back, step through so the swing leg is behind the stance leg. 

BALANCE WITH TRI-PLANE ARM REACHES

A running training program is complete without balance exercises. Balance on one leg - reach both arms up forward, up backwards, right side, left side, right rotate and left rotate. This represents the different cardinal planes of motion. To increase the difficulty alternate reaching one arm at a time. I recommend switching the balancing leg each time so your arms aren't fatigued when it's ready to switch sides. 

PLANKS WITH PELVIC DRIVER

Last but not least planks! I don't perform my planks with a hold. I use my pelvis to drive my body in the 3 planes of motion. Use the pelvis to drive up towards the sky, down towards the ground ( drive with your pelvis, don't let your belly sag), side to side and twist to both sides. To change the exercise and challenge your muscles differently, change the foot position or hand position. I put my feet so they are touching. You can put your feet wide, turn your toes in, hands together, the patterns are endless.

As in all exercise programs, if it hurts don't do it! Consult a professional!