Running without injury to achieve one’s fitness, training, and/or racing goals is the predominant objective of runners. It is important to filter training and treatment fads to understand the true reason runners get injured. Why do some runners get injured while others following an identical training plan do not? The answer lies in observing key movement patterns and asking the right questions.
Simple movements such as walking, running, skiing, reaching, and throwing are comprised of movement patterns we learn at a young age. Movement patterns allow us to move efficiently and repetitively. Factors such as lifestyle changes (prolonged sitting), repetitive motion, muscular weakness, postural changes, prior injury, and range of motion limitations change our movement patterns. These changed movement patterns, which we often do not recognize in ourselves, create compensatory or synergistic movement imbalances. Our risk of injury (micro-trauma, overuse, sprain/strain, pain) increases in the presence of compensatory movement imbalances.Unless a physical therapist screens for addresses movement imbalances, injury treatment will ineffective in the long run.
Understanding a few facts regarding how our bodies move is an important first step in understanding and treating movement imbalances. Skeletal muscle can be divided in to two groups representing their primary function: Stabilizers and Mobilizers. S
tabilizing muscles allow us to maintain the posture necessary for movement. Diminished stabilizing muscle activation leads to movement imbalances and overuse injuries in the lower extremities. Stabilizing muscles (which all runners should work to strengthen) include the gluteus medius, transversus abdominus (lower abs), obliques, lower trapezius, serratus anterior, multifidus (deep low back muscles), rotator cuff, and deep neck flexors. Mobilizing muscles are more familiar to us as they are responsible for moving our extremities: Quadriceps, hamstrings, gastrocnemius, hip flexors, adductors, rectus abdominus (six pack muscle), erector spinae, and latissimus dorsi. In the presence of muscle shortening (secondary to frequent sitting, postural tightness), prior injury, weakness, or repetitive motion activities (involved in single-sport training such as running) stabilizing muscles are inhibited unbeknownst to the individual. For example, in the lower extremities, the stabilizing gluts and abdominals are often inhibited and overpowered by the hamstrings, hip flexors and quadriceps.
A movement imbalance example common in both recreational and competitive athletes is that of hip extension. The ideal muscle firing pattern for proper hip extension is stabilization of the low back with the multifidus and transversus abdominus, extension of the leg with the gluteus maximus, and secondary assistance with the hamstring. A common compensatory movement imbalance for hip extension is contraction of the erector spinae and hip flexors, extension of the leg with the hamstring, and little or no contraction of the gluteus maximus. If such a compensatory hip extension movement pattern is not changed through training, even the most progressive strengthening program will not protect a person from injury or allow him or her to return to running following an injury.
Don’t waste your training time by strengthening compensatory movement patterns which lead to injury! Get the most out of your training through an effective physical therapy consultation.The physical therapy staff understand synergistic compensation patterns which lead to movement imbalances and injury. For more information, call or email the Sapphire Physical Therapy staff. Make 2016 the year you run, train, and compete without pain or limitations. Move well, be well!
John Fiore, PT
Sapphire Physical Therapy