Knees

When running, it’s easy to grasp that one joint can affect another. Throughout the whole gait cycle, we see all the joints of the entire body moving as one poetic fluid motion. Or at least that’s how it’s supposed to be. But what happens when one part misbehaves? How many other joints are affected? More importantly, how do you tell which joint is the instigator, and which ones are feeding off the original? Essentially, when multiple joints appear to be working incorrectly, which is the chicken, which is the egg?

This brings us to AJ’s story. He is a former collegiate runner who has struggled with right lower extremity issues for several years, including knee and hip pains. Let’s see what he looks like initially.

Notice his right foot, specifically that it’s turned out to the side. Also, the landing/loading phase of his right leg looks like it requires more effort. It would be easy to conclude that he could fix his gait by simply pointing his right foot straight forward. But again, what if the root of the issue is in his hips, causing the whole lower extremity to turn out? As we got deeper, this certainly was the case.

For AJ, this pattern is due to limited mobility around his hip region, especially with external rotation. This is causing difficulty during the loading phase. His lack of proper motion is directly affecting his stability at the moment of ground contact. He also demonstrated a moderate overstride as shown by seeing the bottoms of his feet as he’s running toward the camera.

So, what to do about the hips. First, a couple stretches for the outside and posterior right hip.

And another hip flexor stretch, these can be very helpful for proper striding.

Part of the fall out from his foot turning out is that the calf and ankle bones can become restricted, so he also did a calf stretch with a twist.

Next, he ran holding his arms to the right and left. We used this as a test to see which direction promoted better alignment through the hips and feet. See which one looks better to you!

Comparing the sides, when his arms are rotated to the right it increases the turn out of his foot and difficulty with loading of the right hip. When his arms are rotated to the left, it causes better alignment of his right foot and hip. This indicates that the muscles along that pattern need to be strengthened, so what better way than to simply have him run with hands rotated left and holding small weights. He doesn’t look quite as graceful, but that’s okay at the outset of this drill.

Lastly, he also did a modified butt kick drill to decrease the overstride. The important aspect of this drill is to keep the knees equal to each other at the beginning, this promotes feet landing underneath your body instead of out front.

After all this, here’s the new and improved AJ!

His right foot is not turned out as much and his overstride is significantly decreased. Both of these indicate that he is using his hips more effectively, especially during the landing on the right side. With consistent attention to these areas, his foot position and muscle balance should continue to improve and decrease stress on the cranky areas. Great job AJ!