It’s about that time of year when people are beginning or are already well into their running programmes for the marathon season! And this is also the time that we as physios start to see many running-related injuries start to flow through our doors…

This blog is aimed to advise those of you about to start or those of you already into your training with a few tips for injury prevention!!

Now on the whole most marathon or distance running guides I’ve seen seem to miss out one key area…PRE-HAB!!! This basically means getting yourself specifically fit for the type of exercise or sport that you are about to complete to maximise performance and avoid injury.

Many people think that to run long distances; you need to get out there and “just do it!” Though this may be effective for some, for so many we see in our clinics, this is a recipe for disaster.

There are many different types of ‘running’-related injuries that we see, and these often have multiple causes and factors that can be involved.

This blog is going to focus specifically on an area I personally see often causing issues in people who are training to run long distances.

The gluteal muscles and their role in running!!

The glutes

Simply put, the main superficial gluteal muscles are a group of 3 muscles made up of the gluteus maximus, gluteus medius, and gluteus minimus (also involved is a small but very important abductor known as the tensor fasciae latae or “TFL” muscle, which is located more to the front and to the side of the thigh). See link below.

http://www.physiospot.com/wp-content/uploads/2014/07/glutes.jpg

Action

These muscles allow the femur (thigh bone) to move outwards (abduction), to stabilise and align the femur as well as take the hip behind you (extension) when walking or running. Therefore full activation and adequate control are essential in the action of running to not only generate movement but also to control it.

Weak or inhibited gluteal muscles can result in many of the injuries we see in distance runners in our physiotherapy clinics every day.

Without a strong enough gluteus medius, the femur (thigh bone) can become misaligned and drop inwards during running, allowing the knee and ankle to then drop inwards. This then can produce undue stresses onto the inside of the knee joint (possible cartilage damage), can shift the knee cap’s position outwards (possible anterior knee pain) and even over-stress the arch of the foot, causing you to over-pronate leading to further issues such as shin splints or plantar fasciitis.

The gluteus medius muscle’s other main function during running and walking is to help keep your pelvis level as you load from one leg to the other. If it is weak, the piriformis and other gluteal muscles may have to compensate, resulting in them becoming over-dominant and over-worked leading to tightness and spasm, i.e. PAIN!

Other possible injuries that occur as a result of poor glute control can include:

  • Overactive hamstrings (which can lead to low back pain or even muscle strains)
  • Illio-tibial band (ITB) syndrome due to TFL over-activation leading to ‘runner’s knee.’

So…after reading all of this I’m sure you’ll all be asking “how do I prevent this mountain of potential injuries caused by my favourite activity…?”

Well, as I’m sure you are all aware not everyone is the same and this is not a definitive prevention method, however, as a practitioner, I recommend this set of isolated exercises, to begin with, in an attempt to avoid these very common issues to keep you guys out running and not on my physio couch!!

(Following these exercises should you develop further problems it is advisable to obtain a more detailed injury and running assessment with a more functional/sports specific exercise regime tailored to you and your injury.)

All of our Physiotherapists are more than qualified to assess and treat all running injuries. So why not call up today for our new “45-minute running assessment” now at a discounted rate of £45!?

Isolated Gluteus Medius Exercises

Side-lying hip abduction with resistance band

Start with a 10-second hold to feel the muscle you want to work, then aim for 4 sets of 10-12 reps, should not involve any back discomfort.

*if this seems too easy increase the reps or the strength of the resistance band

Bridging with hip abduction using a resistance band

Raise pelvis up and down 10-12 times for 4 sets, keeping the knees splinted apart throughout the whole exercise.

*Should not produce any back pain.

Mini dip with static hip abduction

With slight knee bend on standing leg, making sure to keep the knee in line with the hip and foot, force the opposite knee into the wall for 20-30 seconds to feel the muscle activating

Repeat 4 x each leg

Hopefully, now you are all able to achieve your specific running goals without any issues and can just “JUST RUN IT”!

Best of luck,

Alexei

Alexei works at our Angel and Kentish Town clinics. To make an appointment, call 020 7482 3875 or email alexei@complete-physio.co.uk.

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