At the Core of Running

5 Keys for Injury Prevention in Distance Running

Through our careers in rehabilitation, Alicia and I have been blessed to enjoy running and exercise as a vital part of our lives. We’ve also watched as our patients present with injuries (traumatic and overuse related) that have often limited their tolerance for running, and as a result, their joy and fitness.

In retrospect, MOST of these injuries are avoidable if we combine our brains with our commitment to working out.

Key Number 1: Core Strength

Keep your “powerhouse” strong - the abdominals, lower back, and hips. Core strength enables you to support your spine and execute movements with power while maintaining balance and elongation. A stronger core transmits vital strength from the upper to the lower body and vice versa, increasing the power of the body.

Fig 1: Kneecap over 2nd toe

Key Number 2: Flexibility and Range of Motion

Flexibility in muscles allows your joints to move through their full range of motion without compensation or strain. Maintaining proper flexibility of all muscles prevents injuries in joints by providing either stabilization or adequate movement. In order for joints to stay healthy they need to move through their full range of motion. Inarticulation leads to loss of range of motion, calcium buildup, and arthritis. Excessive flexibility leads to hypermobility and/or joint instability. For running, functional flexibility primarily includes length in calf/Achilles tendon, quadriceps/hip flexors, and hamstrings. The spine and hips also need to be able to rotate, and these are areas that can hide their tightness and present as knee, foot, or ankle pain.

Key Number 3: Maintaining Alignment and Muscle Balance

Most non-traumatic, sport-specific injuries are caused by muscle imbalances that develop over time. Proper muscle balance is obtained by improving the flexibility of overused muscles and the strength of underused muscles. This is where cross-training comes in to play. The narrower your focus on one or two types of athletics, the higher your risk of creating muscle imbalances. The more sports you participate in regularly, the less likely you are to have major muscle imbalances. Both movement yoga and Pilates help to maintain muscle balance by developing the body evenly, front to back, top to bottom, and side to side.

Fig 2

Key Number 4: Train Your Alignment and Focus on Movement Skills

Improve your quality of movement by following these points:

Make sure shin is square to the foot. Point your foot forward so that the 2^nd toe is aligned with your kneecap. (see Fig 1)
Maintain the pelvis square to the line of running. Imagine your hip bones to be two headlights on a car, always facing forward. Maintain the “neutral alignment” of pelvis so that the two front hip bones and the pubic plate stay in the same vertical line. (see Fig 2)
Try to minimize sway from left to right and stay centered over your hips. Minimize bouncing up and down or locking your knees and keep your head level.
Wear properly fitting shoes that provide a combination of cushioning to buffer repetitive impact and help in guiding your weight over each foot once you know the desired path.

Key Number 5: Breathing and the Mind-Body Connection

A strong mind-body connection requires concentration and focus. This connection is critical when engaging in sports so that you avoid injuries. Your breathing has a significant effect on your ability to stay connected. Patterns of hyperventilation and breath holding can affect you adversely. By using the Pilates type breath (taking the breath through your nose into the lower lobes of the lungs and expanding your ribs to the sides and posteriorly, then exhaling through pursed lips) you will stay dialed in to your heart rate and exertion levels and dehydrate less quickly. Nose breathing stimulates the parasympathetic nervous system, which helps to calm the body so you will be both exerting energy and calming your body at the same time.

In addition, keeping your “heart toward the heavens” or lifting your sternum will open up your chest and allow proper breathing.

The goal of all exercise is health and wellness. Like all forms of medicine, it needs to be administered with intelligence and in the proper dose. Good preparation can keep you running strong, healthy, and injury free.

By: Chuck Hanson PT, OCS and Alicia Randolph PT, ECS, Stott Pilates Certified Instructor

Chuck HansonPT, OCS and Alicia Randolph PT, ECS, Stott Pilates Certified Instructor (husband and wife) are founder and physical therapists at Therapeutic Associates North Lake Physical Therapy. This August they are celebrating 20 years serving North Seattle in the Lake City Professional Center.

This article can be seen in NW Runner, June 2009.