Do you know how, when you buy a new car, you suddenly notice all of the other cars on the road of the same make and model? It's happen to me every time. I guess the same can be true for injuries. I've definitely had my share, the latest being IT Band Syndrome that prevented me from running the Ogden Marathon last Spring.
Ever since then I noticed a lot of other runners having the same problems. It seemed to be more than normal, but again, perhaps since I was experiencing it for the first time I noticed others who had it too.
I spoke with a few of my fellow runners who had the same problem and given them bits and pieces of what I learned from five months of physical therapy. Each time I promised to write a post on it - and now I'm finally getting around to it.
If there's one thing I took away from my PT treatments, it was the importance of core stability. The core controls everything - movement in the upper and lower areas of the body.
The core is not just your abs. It's also your back, hips, glutes - pretty much everything in the center of your body. And if one thing goes out of whack, then everything else can too - it's all related. This is why your core muscles need strength and flexibility to maintain balance. Imbalances can cause misalignment and injury.
In the spirit of "putting myself out there", here's a video that my PT took of my running gait:
After filming this, I was asked what I saw. To be honest, I really didn’t know what I was looking for. But then it was pointed out to me that my left foot does all the work while my right foot just kind of drags along. My hips were imbalanced and not stable.
I found a great paragraph in this article (it's a good one, read the whole thing) that explains what was happening far better than I ever could:
"A great example of this is the effect of weak gluteal muscles on the knee and foot. If gluteus medius and gluteus minimus (our primary hip abductors) are weak, the femur will tend to adduct and internally rotate. If you follow this down the kinetic chain, the knee will fall into a “knock-kneed” position and proper knee tracking will be disturbed, the foot will tend to pronate. The smaller leg muscles are not able to make up for the weakness of the gluteal muscles and a number of injuries (IT band syndrome, Achilles tendionosis, plantar fasciitis, & shin splints) can result along the lower kinetic chain."
Personally, I never experienced pain in the IT Band itself - the pain manifested itself in my knee. And it was debilitating.
I now do the exercises prescribed by my PT religiously - at least once (sometimes twice if I have time) a day.
I've combined the many exercises into two sets - one standing, and the other lying:
Standing on a step or stool: 1. Single Leg Dips 2. Skateboarders (like you're riding a skateboard) 3. Reverse Skateboarders 4. Frog Legs (kick the hanging leg out, then raise the hip and bend the knee to bring it back to standing) * 30-reps on each leg
I do this set of exercises before a run. The key for these exercises is to think about placing your weight on the heel of the foot planted on the step so you engage your glute muscles. You also want to be sure you are not overly dipping your hip. The movements can be very small, but it is still effective. Also, I will lightly place a finger on something to help me stay balanced and not fall over.
1. Bridge 2. Clam Shells 3. Leg Extension Side Kicks (lying on your side, extend the top leg behind you and turn your toes out, heel in) 4. Overhead Abdominal Pulls with a medicine ball or bands (focus on engaging your transverse abdominis aka lower abs) 5. 90-degree Clam Shells (knees at 90-degrees) 6. Leg Extension Back Kicks (same position as #3 but you are extending a bent knee back/forth) 7. Elevated Clam Shells (heels together and elevated) * 30-reps (on each side as needed)
Doing these exercises can be very nauseating, especially at the end of a long day. But after doing these exercises regularly for six months I no longer have knee pain. Both my PT and chiropractor have noticed a significant increase of strength in my hips which has been incentive enough for me to keep it up.
Some other things that have helped me are: • 3/4 Single-Leg Squats: If you think about, every step you take when you run is a three-quarter single-leg squat. Doing this exercise helps to build knee stability. My goal (that I am still working on) is to do 50 on each leg without any internal knee rotation aka instability. • Walking up a hill or on a treadmill at an incline and REALLY focus on engaging you glutes. • Dragging on foot on the treadmill, at a very slow speed (0% incline while the other foot is standing on the edge) and again, think "engage glutes" • Think about externally rotating your hips during the first min of each mile.
Doing all of these extra exercises, in addition to my regular training takes a lot of time and effort. But it’s paid off. Combined with a few minutes of daily yoga, and periodic acupuncture and chiropractic treatments, I was able to overcome my nagging IT Band Injury. And now I know what to do to ensure it doesn’t reoccur.