Flexibility

We can all agree that overstriding is a bad thing when it comes to running. Simply put, overstriding is when your foot lands too far in front of your hip at the moment of impact. So, the questions become, how do I know if I’ve overstriding? and how do I fix it if I am overstriding? It is very easy to want to focus on your feet, and perform drills to develop proper foot placement. These are often helpful, but what if the dysfunction is coming from somewhere else?

This brings us to Aaron’s story. He has run several marathons and is gearing up for another this fall. He is also eyeing a late summer triathlon. As we met up for our session, he remarked that he has had intermittent right medial knee pain with running. As our session started, it looked like hip strength/flexibility/efficiency was going to be the focus. A moderate overstride was present, but it didn’t appear to be the most critical element of his form. But at the end, with focusing on his hip function, the overstride diminished. Again, this wasn’t the initial goal, but the result was too cool not to bring attention.

Here is video of him initially.

One of the clues to look for if you suspect overstriding, is if you can see the bottoms of his feet while he is running toward you, then he is likely guilty. What else is present on the right side is a hard landing through his hip and slight toe-out. Essentially, if he’s not using his hip to absorb the landing adequately, combined with his foot turning out, extra stress is placed on the inside of his knee.

Another note on overstriding, when you do it, it increases the impact through your legs, hips, and core and doesn’t allow you to use muscles efficiently. On the flip side, if you can teach your hips to work more efficiently, this can cut down on your overstride, as we’ll see as Aaron’s story unfolds.

Here’s another assessment tool for hip stability, notice the position of his knee as he gets deeper into the squat. His right knee goes inward further than the left, which is a sign of poor stability in the right hip.

What to do about it? First an exercise to build strength/stability in the hip, again notice it’s more of a struggle on the right side.

Also, a simple stretch for the gluts.

Next, we went caveman style to build further hip strength and quickness of load/response. Holding weight overhead forces his hips to work harder to load and push-off.

We also transferred that into a form drill. Notice the overstriding is already going away!

After all this, here is footage of him running.

Again, the overstriding is greatly diminished and he looks much more efficient through his hips and upper body. As mentioned above, if you can see the bottoms of his feet as he’s running toward you, that’s not a good thing, and he looks much better with this after doing the exercises. Also, notice his toe out is decreased.

So, the take home message here is that the area with the greatest flaw in form may not be the place to start correcting it.

With constant attention to these areas, it will make a huge difference for decreasing the knee pain and improving his efficiency as a runner. Great job Aaron!

How do unhappy hamstring muscles affect running gait? We’ve all heard about hamstring flexibility, but what about hamstring strength? And more specifically, are they firing at their proper times in order to stabilize the knee and pelvis during running? Check out a previous post to get a more thorough dissertation on hamstring function.

On a practical note, here is Brad, a former collegiate sprinter and current superstar triathlete. He has had nagging pain in his left hamstring and posterior knee. Here is video initially.

And here’s another at a faster speed.

It’s subtle, but if you compare his left knee to his right upon landing, a slight lag is present. More specifically, upon landing his right knee stays slightly bent, but his left knee has a little sloppy movement toward hyperextension. When this is present, the posterior knee joint is under stress with every step taken. Could this be a cause of your posterior knee pain?

He also shows a slight asymmetry with his arm swing, with rotation more to the left than the right. An asymmetry like this is usually tattling on the legs. For Brad, it’s a compensatory pattern to make up for his gluts not working properly.

To dig a little deeper, here’s a simple test for hamstring function. See if you can discern a difference between the right and left sides.

Of course, the best part of the this video is his son showing off, but as you can see, his left knee is slightly more wobbly than the right. This indicates a lack of stability, especially as the hamstrings and gluts come under further load.

Here is where the breakdown occurs. It is a common pattern for the gluts and hamstrings to be partners in crime. This is often a combination of lack of flexibility, as well as lack of strength under load.

So here is what we did for Brad. A simple ground reach to load the gluts and hamstrings, exploding up to a running pose.

Next a simple stretch for the gluts. Another variation can be done using a table or similar height object.

Next, power skips to develop quickness and power during the load-to-push-off transition.

And lastly, running with his arms out to the right side. This accomplishes two things. First, working on symmetry of upper body movement, and second, taking the gluts out of the equation and forcing the hamstrings to fire up more quickly.

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

His upper body is symmetrical, which indicates better muscle balance through the legs. More importantly, his left knee looks more stable during the transition from loading to pushing off (other than the slight wobble on the 2nd step due to the uneven ground!). Great job Brad!

Again, what he presents with is very common and can be improved with attention to the gluts and hamstrings. If your running buddy has similar patterns or nagging issues, please pass this along!

This week’s spotlight is on Elizabeth. She is in training for her first half marathon and began experiencing left lateral knee pain following a 10 mile training run. She has been very active with team sports and plyometric workouts in the past, but running 10+ miles is uncharted water for her. Here is video of her running initially.

The thing that jumps out the most is the apprehension to load the left leg. The load-to-push-off transition should look very smooth, but her’s is certainly a little jerky (there’s probably a more technical term out there but we’ll roll with this one!). This type of pattern can come from the foot, calf, knee, hamstrings, or hip. Upon closer exam, she was very tight in the lateral hip and IT band.

These areas are especially critical during the loading phase of gait as the lateral hip should be where the majority of the shock of impact is absorbed. If this doesn’t happen gracefully than the IT band can easily tighten up and cause increased friction at the knee.

The other thing that jumps out is how much her arms and upper body rotate, a little more than ideal. The arms often tattle on how well the hips and core are dealing with the forces entering and leaving the body. See the last blog post for a little more on this and what to do about it!

But here’s what we did to get Elizabeth going again. First the good old foam roller to her IT band.

Next a two-stage stretch for the lateral hip.

After the foam roller and stretch, her hip flexibility already showed improvements, so here’s footage before we monkeyed with form drills.

As you can see, her left leg looks much smoother, but we’ve still got the extra rotation of the upper body and arms. So here’s what we did to address the form. First, power skips.

Lastly, she ran with her arms out to the sides. This increases the rotational lever arm and forces her lower core to be more stable while running.

As she did the last drill, she commented on how hard it was to keep her arms from swinging around. Again, what this does is teaches the lower core and hips to be able to more quickly and efficiently load and rebound to push off, rather than pass the buck to the upper body.

After all this, here’s the new and improved form.

Again, her landing and push off look much more efficient. Her upper body has less rotation to it, even though she looks a little over cautious in the last video. Ideally the arm swing is relaxed and relatively forward/backward. Her’s is certainly a step in the right direction. With consistent attention to her flexibility and improved form, this will keep stress off her knee and improve her efficiency. Great job Elizabeth!