Happy Hips

As you likely know, the hip is a huge ball and socket joint that is relatively stable and yet maintains a fair amount of joint range of motion.  Because running is a repetitive motion which requires that our lower limbs bear 2.5X our body weight each step, the hips take a great deal of load in any amount of distance we run.  What's helpful to know is that strength is only one component of well-functioning hips.  Many people rightly attempt to strengthen the muscles surrounding the hip joint but what they may neglect are exercises which train their hip control and stability.  This is especially important for runners as we are essentially hopping from one foot to another.  If you have poor coordination and balance on one leg, you cannot control loads very well when you're running.  Symptoms of poor hip control can manifest in lower extremity injuries or areas of chronic stiffness (i.e. tight regardless how much you stretch).

So without further ado, give these exercises a try in your running routine for a few weeks and see if you find your stride feeling smoother and your body less sore overall.  I typically do a few of these exercises pre/post run and will sometimes do longer sessions on days that I do not run.  Shoot for 3 sets of 10-15 repetitions for the first 3 exercises and 5 rounds for each leg on the Star Reaches.  Finally, using a mirror or other visual feedback may also help ensure your form is correct.

1. Hip Drops

Start on a step with a level pelvis, keep both knees straight during the entire exercise.  Lower your leg SLOWLY by pushing the hip of your stance leg out to the side.  This will cause your pelvis to drop on one side.  Avoid leaning your torso.  Raise your pelvis back to the starting position using the hip of your stance leg.  You should feel the work mostly in the side of the hip of the leg you're standing on.

Starting position with a level pelvis.

In this case I am pushing my right hip laterally to the side to drop the left side of my pelvis.
Keep both knees straight and make sure to control both the lowering portion and the returning to a level pelvis.

2. Single Leg Balance with Hip Flexion

In this exercise you are simply flexing one hip to 90 degrees while maintaining good balance and control.  You can use a resistance band to increase the difficulty.  Keep your torso upright during this entire exercise.

Starting position

Finish position.
Keep your balance and a tall spine!

3. Single Leg Romanian Deadlifts

Stand on one leg with a slight bend in the knee.  The goal of this exercise is to bend forward from the hip as much as possible without moving the spine.  Keep your spine straight during the entire exercise, your back leg should remain extended in line with your spine.  To bend forward, push your hip back until you feel a good stretch in your glute muscle.  Once the hip stops bending, return to the starting position using your hip (not extending with your back).

Starting position.

Finish position.
Keep your spine locked with your back leg so that everything is in a straight line.
Bend through your hip as much as possible while keeping the spine elongated
(i.e. this works your hip hinge).

4. Star Reaches

Again stand on one leg with a slight bend in the knee with 8-markers placed in a circle around you.  The goal of this exercise is to bend from the hip as much as possible as you reach for each of the markers.  Reach each marker separately by returning to the start position before reaching for another marker.  This will challenge your balance and your hip control more effectively.

Forward reaching.

Side reaching.

Contralateral posterior reach.

Bend So You Don't Break

Truth be told, I’m getting excited for sandal season to start again.  I am solidifying my race calendar and I am planning to cap the year with the Leadville 100-mile trail run and maybe even another Spartan World Championship.  As each of us look to our summer and fall running seasons I wanted to share one of the best and most simple form fixes you can implement now to give you a more successful season.

One of the most common mistake runners make in their form is to over-stride.  Over-striding can be defined as any form of landing that causes a braking force.  One of the easiest cues to help remedy this situation is to simply “bend your knees more.”  In theory, when we are running we are using our legs as giant springs.  If our knees are not flexed enough during running gait we are more likely to land with the foot too forward of our center of mass.  This forward foot landing creates a brake and diminishes our forward momentum.  This braking effect leads to higher impact forces and reduces our running economy.

Need a good example of the difference bending your knees can make?  Compare yourself running up a steep hill versus down the same hill.  Because it takes excessive effort to over-striding while running uphill, most people don’t do it.  They instead bend their knees more and take shorter steps.  On the other hand, over-striding is very common while running downhill.  Film yourself running downhill, then repeat with your knees bent deeper.  You should see a smoother decent with your knees bent more (i.e. less bobbing up and down).  Combine this with an increased cadence and the results should be less achy hips and knees.

In addition to bending the knees and allowing your leg springs to work, I also like to focus on relaxing my calf muscles and the tops of my feet.  Bending your knees more should help to relax your calves naturally but if you’re used to holding excess tension in your calves and feet, you might want to cue yourself to relax further.  Many runners who over-stride will also demonstrate increased vertical oscillation (i.e. bobbing up and down).  Following the aforementioned cues can improve your efficiency and likely allow you to train more miles and a faster pace due to less impact forces.

Bending the knees helps you land with your foot closer to your center of mass.

Filming your gait can be your best tool because sometimes what we think we are doing is not what we are actually doing.  I often use film for my runners so that they can compare how different cues change their gait.  When we see improved efficiency and when the runner feels smoother and more comfortable, we know that we’ve found the right cue.  I have found over the years that “bend the knees more” has been one of the best cues to reduce impact forces and smooth out gait.  This is especially true for downhill running when runners are most likely to over-stride.  Experimentation is the foundation of learning so it’s up to you to give these cues a try and see how your body responds.

Best wishes for a happy and healthy running season!

Firefighter Success Story

My apologies for the lack of NPR posts as of late.  I joke with my friends and family that I have about 5 jobs (things I get paid to do), and like most of you, a dozen or more regular roles I play.  Still I really am quite passionate about sharing good information (and stories) when I can get around to it and today is one of those glorious days.

As you all know, I have been obsessed with feet and their function since I made my own transition to barefoot running (and more minimal shoes/sandals).  In my own transition, I was quite horrified to realize just how damaging the myths of footwear have been to both myself and most in our modern society.  This along with running form and training methodology are perhaps my favorite topics of discussion (at least in the rehab and performance world).  I also love everything related to the outdoors, coffee, and building things.

So without further adieu, I wanted to share this success story from a fireman who lives in the Nashville area and reached out to me last summer through our mutual friend.  I'll start from the beginning when "Q" contacted us through our website...

Hello,

I am a paramedic and a firefighter and I watched some of your YouTube videos that a mutual friend (JP) showed me for feet exercises. I looked up your website from the video and saw that y'all offer a discount for first responders. I just wanted to say thank you and let you know it is much appreciated. If I didn't live in the Nashville area I would probably be a client, but I just wanted to say thanks for the information and offering us a discount!

I replied with a few additional resources.  "Q"s personal story is more in-depth on his next email response.

JP actually showed me some of your YouTube videos and I found your blog after that. I developed plantar fasciitis over two years ago. It was mostly from jogging hours on end barefooted with my daughter that had colic (it was the only way to get her to not cry) and heavy turnout gear for work. I went to the podiatrist and she said I had "really flat feet" and said I pretty much just had to live with it, wear orthotics, and never go bearfooted again.  I have pretty much completely quit running and changed my whole PT (training not therapy) regime to cope with it. While the plantar fasciitis has gotten better, my feet over all are weaker and ache more than they used to. I started reading more stuff and came to the crazy hypothesis that through PT I could strengthen my feet and even maybe not be flat footed anymore. I was asking JP's input on my theory and that's when she pointed me in your direction. For the first time in a couple years I feel like there is hope and I won't be hobbled and decrepit! I know that might sound a little melodramatic, but as much time and money as I have wasted trying to find the right insoles, shoes, orthotics, and so on with no real solution, maybe it's not. I am just amazed that someone can have a doctorate in feet and be so terrible at feet (in reference to the podiatrist I went to, and have had friends/coworkers with similar experiences). That's why I wanted to email y'all and say thanks for putting so much good and free information out there! I started doing exercises almost a week ago and already have noticed an improvement. Tomorrow when I am on shift, I will start to implement the stuff from your blog.

I hadn't heard from "Q" since last July until yesterday when I received this email.

Hey Sam, it’s been a while since I emailed you. I am JP's friend that is a firefighter that had flat feet. I just got done with my annual work physical and my doctor (former Brigadier General for the Army) called me a “dumb shit.” I was honored! I figure after a full military career and 49 years as a MD, doing something to illicit being a “dumb shit” from a Church of Christ, retired General was quite a feat! 

We got to the interview portion of the physical and he asked about my flat feet. I wore shoes today to avoid having to explain myself, but it didn’t work. I told him I had been working on them. He asked what that meant. I told him I have been doing a lot of physical therapy exercises and running barefoot and that I have got to where I can run a mile with no problems. It was at this point he sat straight up in his chair and called me a dumb shit. I took my shoes off and showed him my feet. He starred at them, stuck a finger under my arch and said, “You have arches! I guess we will take that off your record. So how does one go about rebuilding their arches?” I demonstrated several exercises and explained my position on feet have been weakened by shoes and are not allowed to function as designed. He didn’t buy it and I did not convert him, but he could not argue with my arches. 

I showed him a YouTube video showing the natural versus shod running forms and the differences of impacts on pressure plates and he said I was still a dumb shit but he did hear me out. I figured you would get a kick out of it, but also hope it’s encouraging! Thanks for putting your blog and videos up, because I was feeling kind of hopeless and doomed to a life of hobbeling around and not running and playing with my kids before I started the transition. Thanks for the help and I hope you enjoyed the story!!! 

Thanks! Q
PS I have gotten up to running 1 mile barefoot in the grass with no problems!!! 

Wait what?! You strengthened your arches???

Right medial arch before strengthening

Right medial arch after strengthening

Left arch before strengthening

Left arch after strengthening

The email from "Q" highlights a great story of self-discovery, discipline, tenacity, learning, and growth.  I believed many of those same myths prior to my experimentation and once you're on the other side you begin to realize how many beliefs turn out to be ridiculous and very limiting.  I've stated many times that permanently casting/bracing the feet makes no more sense than doing the same to any other body part.  I previously highlighted Barefoot Matt's story which is quite similar.  Having bunions and imperfect feet myself, I resist the idea that one's foot has to look like the ideal in order to go barefoot.  What we need are strong and flexible feet, good reflexes, and muscles/tendons that have undergone smart training.  No one preaches that everyone with scoliosis should avoid loading the spine for the rest of their lives because it's not perfectly balanced.  I hope you raise an eyebrow when someone suggests that permanently limiting the use of a body part is the answer to your injury or mal-alignment issue.  As a therapist I can only say, welcome to the mal-alignment club...now let's learn to move better.