Kim Mulvaney, Physical Therapist Assistant, Christie Clinic
Are you one of those people who have to train really hard, run for weeks leading up to a race, and progress your speed and distance slowly in order to achieve your running goals? Running is particularly difficult for you, maybe even painful, but you still have the desire to run for exercise or to participate in a race. Your heart is in the right place, as you want to push yourself, feel strong, and get healthy. All the while, there are people out there who have not run in months, perhaps even YEARS, and can go out and run 5 to 10 miles with hardly any issue. What is with that?!
Well, it could be that you simply are not made to be a runner.
Now bear with me here! I am not saying that you can’t be a runner, or that you should avoid it. The truth is that some people’s bodies are built to endure running more efficiently and effectively compared to others. We are all built differently, and I am not just talking about different genders here. Some people have longer legs, wider hips, lower tone, hypermobile joints, and so on, that will affect their ability to run.
So, what do you do if you are the type of person who finds running particularly challenging or painful but you still have the desire to participate in a race? No, you don’t have to settle for another form of exercise you don’t particularly enjoy, though running is not the be-all-end-all, and other forms of exercises are equally as beneficial. Here are some tips to help you get ready for race day without causing injury or feeling like you are just suffering through training.
It’s all in the hips!
In our physical therapy department here at Christie Clinic, we often see people with pain or an injury resulting from their running training. After a thorough evaluation by a physical therapist, patients are often informed they are weak in certain areas of the body, leading to altered mechanics of their running gait and subsequent pain and injury.
The response we often hear is, “But I run on a regular basis! How can I be weak?”
First off, it is not that you are “weak.” It simply means you likely have weakness in certain muscle groups, primarily stabilizing muscles, that lead to the ailments you are experiencing. Lack of strength in the hips is a primary cause of pain or difficulty with running. Whether your goal is to increase speed, distance, or just to complete the race without aches and pains, you must strengthen the hip muscles.
The gluteus maximus and gluteus medius are crucial muscles that have to be strong in order for you to be an effective runner. I’ve heard it said before weak gluteals are the root of all evil! In the PT world, this is very true. These muscles provide support to the low back, pelvis (including SI joints), hips, and knees to name a few. They aid in proper positioning of our knees as our feet make contact with the ground and transfer pressure upwards through our bodies.
For instance, women typically have a sharper angle from hips to the knees. This shape can cause uneven forces about the knee joints. The gluteus medius is like the power steering, providing proper alignment of the knee-to-hip angle (or “Q” angle) while the gluteus maximus is the engine, propelling you forward during push-off during the running gait cycle. However, working our buttock muscles is not just for the ladies. Men very often have significantly weak gluteals. Do not disregard the importance of strengthening your booty!
Simple exercises we frequently prescribe for the gluteus medius include side-stepping with a band around the ankles, side lying leg raises against gravity, and clamshells in side lying (think Jane Fonda)! Gluteus maximus strengthening exercises include lunges, bridges, and prone lying leg lifts.
Core Stability
A strong core is essential to being an efficient runner and preventing injury, namely the transverse abdominus (TA) muscle. Forget the rectus abdominus (ok, don’t completely forget about it), the TA muscle is where it’s at! If you want to run without increased low back pain, or pain throughout your entire body for that matter, being strong in the core stabilizing muscles is essential. If you do not have stability in your core, then you cannot have stability in your extremities.
The TA muscle acts as the body’s back brace, or corset, if you will. When it is activated, it compresses our abdominal cavity. This provides stability to all the joints it attaches to, including the lumbar spine, ribs, thoracic spine, and pelvic bones, which will have a chain reaction to providing stability upwards and downwards throughout the rest of the body.
If you are someone who gets back and hip pain with running, no doubt you likely have weakness in your TA. Doing some very simple exercises to strengthen your TA will aid in improved stability throughout your low back and pelvis, allowing for improved knee mechanics (along with those gluteals) and a more normalized running gait. Plus, you might tone up your tummy a bit!
Great exercises for this include forward planks (be sure you keep your low back flattened for this one) and the TA contraction. Simple and effective!
Stay Loose
Many physical ailments result from muscle imbalances in the body. Some muscles are weak while other muscles get overused and become too tight. Ever experience a tight low back, hamstrings, or calf muscle? Yep, these are due to muscle imbalances causing these muscles to do too much work while the others are slacking off. Again, this causes our joints to be moved in such a way that is dysfunctional and results in pain and injury.
Three muscles that frequently need to be stretched in runners are the hamstrings, the hip flexors, and the gastroc-soleus muscles. With each push-off through our feet, we are using a power-house muscle known as the gastroc-soleus complex, or calf muscle. This muscle must be able to propel our body weight from the ground. When the gluteals are weak, the calf muscles have to work overtime to help propel us forward with each stride (remember, gluteus maximus = engine power)! If we do not frequently stretch it out, it will tighten up. The fibers of the Achilles tendon (where the gastroc-soleus attaches to the bone of our heel) became irritated and inflamed, hence the ever-so-common ailment of Achilles tendonitis. Keeping the calves strong is very important as well, but stretching them allows these muscles to stretch back out after repetitive use.
Weak gluteals also contribute to increased hamstring tightness. The hamstrings must be strong as well to propel us forward during running, so when the gluteals are weak, the hamstrings become overused. Not only can this cause hamstring discomfort, but it can also lead to low back pain as the hamstring muscle originates on our buttock bone, in turn pulling downwards on the pelvis and altering our low back alignment. After each run, be sure to stretch out those hamstrings.
You may have seen people doing a forward lunge type of stretch for running. There is a misconception that this is stretching the hamstrings, when it actually stretches our hip flexors. These muscles work to pull our leg forward with each stride, opposite of the gluteals and hamstrings. In addition to the repetitive motion running causes on the hip flexors, our lifestyles cause these muscles to tighten. Prolonged sitting puts the hip flexors in a shortened position, as we are often required to do for our jobs and daily commutes.
The hip flexors originate on our lumbar and sacral spine and the pelvis, so as they become tight and shortened, they pull on these joints in ways that cause altered positioning through the hips and low back. Therefore, causing increased low back pain (not to mention hip and knee pain).
Doing dynamic stretches before a run (stretches with movement) and static stretches after a run (prolonged holds with stretching) are appropriate ways to prevent injury while running. Be sure you are doing a little of both. Only a few minutes can be extremely effective!
Know Your Limits
If you are someone who struggles to run or experiences pain while running, don’t be discouraged. Improving our muscle imbalances can greatly affect our ability to run faster, longer, and with less pain. However, when you are training for a race, it is most important to know your limits.
The old saying, “No pain, no gain,” may have worked when you were 16 and on the football team. If you are an adult, know the difference between ok pain and bad pain. What I would consider “ok” pain would be a minimal to moderate burning sensation in your muscles. This is likely muscle fatigue and is essential in building up our muscles and endurance. However, if the pain is severe, take time to slow down and walk for a bit.
“Bad” pain is what I would consider sharp or a strong ache in nature. This often occurs prior to an injury and is basically your body warning you that something isn’t quite right. It doesn’t mean that you necessarily have damaged a ligament or other structure in your body, but rather it is a sign that you have done enough for now. No harm, no foul, just know that this means it is time to rest for a bit.
If you have never been a particularly good runner, we are here to help! Try the above recommended strategies to help you in your training. If pain persists, you may need a more in-depth physical evaluation. Give us a call here at Christie Clinic Department of Physical Therapy (217) 366-1323 and schedule an evaluation with a therapist to ensure you are training appropriately and not ignoring any underlying issues.
*this article is provided in partnership with Christie Clinic
