By: Dr. Patrick O’Brien
Your Hips Don’t Lie
Your Hips Don’t Lie
When you begin running or you decide you need to add strength training (which ALL of you reading this should do) to the training routine, the focus is typically misguided. Typically runners focus on the major muscle groups they are familiar with like their hamstrings, calves, quads, and abdominal muscles. Don’t get me wrong, those are important, but you are ignoring one of the most important muscles involved in running. The gluteus medius. What is that, and what does it do?
When your gluteus medius activates it lifts your leg out to the side. So now you’re wondering what the hell that has to do with running. Nothing, however, when you are running the gluteus medius’ job is to stabilize your pelvis when your foot hits the ground.
When your right foot strikes the ground, your right gluteus medius activates to keep your right hip from collapsing inward which in turn keeps your right knee from collapsing inward (picture your foot hitting the ground and your knee moving inward aka “knock knee” posture). Repeat that movement over and over throughout your run and you have a recipe for disaster.
As a Physical Therapist, I treat an overwhelming amount of patellofemoral pain. Fancy name for knee pain. The typical course starts with a physician visit due to this worsening knee pain. The physician sends them home with an order for therapy and an anti-inflammatory. Once I see them for the evaluation and I test their hip strength, they realize they are extremely weak in their hips. I explain the relationship of the hip to the knee and how we are going to treat their knee pain. Many times, I can tell that they aren’t on board initially. They agree to the care, but they aren’t sold that I know what I’m doing.
We start with hip exercises, and some combination of tissue work depending on their symptoms and the acute or chronic nature of their injury. After 2-3 weeks of diligent exercise progression in the clinic and good compliance with their home exercise program, the light bulb goes off and their pain is improving. Now they are on board. The duration of their treatment is directly related to compliance with exercises and gradual return to sport.
So what should you do now instead of waiting to get injured?
Go on youtube and do a search for hip strengthening exercises for runners. Start with the basics like clam shells, crabwalks, sidelying abduction, etc. You need to do multiple sets of these exercises 4-5x per week. Pick three basic exercises and start there, but you also need to progress to more dynamic exercises once you gain the initial strength and control. Working towards exercises that are in standing like hip hikes, step downs with heel taps, etc. Focus on slow controlled movement and focus on form. Otherwise you are using other muscle groups to compensate for your weak glutes.
I hope you have gained a better understanding of the importance of your hip muscles as it relates to running and the preventative measures that will keep you from visiting me at the clinic.