Running overuse injuries impact nearly 50% of runners annually.   Preventing running injuries requires wise training, consistent strength training, and adequate muscle length to insure proper joint motion.  When a running overuse injury does occur, listening to your body and seeking appropriate medical advice will shorten your running interruption.

As a physical therapist and a runner, I have treated and experienced a multitude of running-related injuries.  Over the past twenty years I have noticed several patterns which consistently appear with running injuries.  One such pattern involving the hip flexor musculature relates to many lower extremity running injuries.

The hip flexor musculature includes the following muscles:  Iliopsoas, tensor fascia latae (TFL), sartorius, and rectus femoris.  Collectively these muscles drive our leg forward as we run.  Often the hip flexor musculature becomes the dominant muscle in our running stride which creates a muscle imbalance.  The TFL becomes the go-to muscle in the presence of gluteus medius weakness and “disguises itself” as a hip lateral stabilizer.  The rectus femoris becomes shortened with prolonged sitting and in the presence of lower abdominal weakness.  The iliopsoas, however, is consistently a muscle which can create asymmetries related to multiple running overuse injuries.

Deep to the abdominal region is the psoas muscle.  The psoas originates on the lumbar vertebra.  Its cohort, the iliacus, originates on the inside of the ilium (pelvis).  Both muscle blend together and attach to the upper femur.  The iliopsoas muscle group flexes the hip but also serves as a secondary “strut” or stabilizer of the hip.  Often tight and short in runners and cyclists alike, iliopsoas tightness in runners can be particularly problematic.  Every running stride results in up to eight times our body weight per step.  The iliopsoas is a muscle which will try to do it all in the presence of surrounding muscle weakness.  An iliopsoas imbalance on one side, therefore, can cause leg torsional forces and overuse injuries.

Assessing iliopsoas muscle length and function are crucial components in the prevention and treatment of running injuries.  Deep tissue mobilization, manual physical therapy techniques, and biomechanical running analysis are effective means to determine if your iliopsoas is contributing to recurrent running pain.  Call or email Sapphire Physical Therapy if you have questions about your running mechanics and how it may be contributing to your injury risk. Addressing asymmetries now will enable you to achieve your running goals later.

John Fiore, PT
Sapphire Physical Therapy