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Wednesday, 06 February 2013 19:52

Get strong, improve stability and reduce injuries.

by Sam Ziman Senior Physiotherapist - A sports physiotherapist's perspective

We are coming up to the London marathon and as the weeks go by, your mileage is increasing and there are more and more people coming into the clinic with running injuries and pain.

Whether you are training for the marathon or just a weekend warrior, you may have some weaknesses in your lower limb muscles leading to pain and injury. Running is not enough to improve strength especially if you have had injuries in the past.

What type of exercises should I do?

The type of exercise is important, exercises should be in functional positions. If there are major weaknesses you may need to start with mat work, however this should quickly move into functional positions ie: standing. For strength benefits you may consider squats and lunges however for muscle activation benefits you may consider single leg exercises to improve stability.

One group of muscles that are really important for pelvic stability are your gluteal muscles ( in your butt ). These muscles keep your hips symmetrical when running.

One way we assess your pelvic stability is to have a look at your single leg squat. This test is great as it gives us not only an idea on weaknesses around your hips but also around your knees and ankles.

What are the signs of instability?

knee-alignment-southfields-physiotherapy

A dynamic knee valgus is a sign that you have pelvic +\- knee instability. A dynamic knee valgus is when your knee caves inwards. Depending on the extent of weakness this can happen in a double leg or single leg squat and also while your running. Dynamic knee vagus has been linked to ACL injuries, patella femoral joint pain and the big one in running, Iliotibial band friction syndrome (ITBFS). It has also been linked to gluteal tendinopathies and hip pain.

Another sign of reduced pelvic stability is a hip drop. When you are squatting on one leg the opposite hip will drop down indicating gluteus medius weakness.

This photo of a right single leg squat shows a knee valgus and a hip drop, however you can have one without the other.

How to perform a single leg squat?

Stand in front of the mirror, stand on one leg and then bend your knee keeping your back straight. Does your knee cave in? Does your opposite hip drop?  These are signs that you need to start strengthening exercises.

One exercise I really like is to stand in front of the mirror and correct your single leg squat. With your hands on your hips,feel for your ASIS, the bony protrudences on the front of  your pelvis. Perform a single leg squat, tighten your abdominals by drawing your belly button into your spine and try to keep your hips level as your knee bends ( your hands should stay symmetrical).then look down at your knee,  focusing on keeping your knee inline with your toes. Start with a 1/4 squat and repeat with good technique x10-20 times twice a day. This exercise will start to train your muscles to activate in this movement. 

It is very important to do this in front of the mirror so you can see what your hip and knee are doing!

This exercise is not just important for runners, but very useful for skiing, tennis and football.

I hope this has motivated you to start thinking about strengthening.

If you have any questions, or would like a professional assessment/treatment get in touch with me directly by email at This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it. or phone on 02088708462.

Good luck in your training!!


Samantha Ziman

Physiotherapist

Read 18950 times Last modified on Monday, 22 December 2014 19:02
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