This is Caleb, an elite collegiate runner. He has had intermittent pain in his left medial/anterior knee, medial shin, and lateral hip. Watch the video of him running to get an idea of where this might be coming from.
As you can likely see, he has a lot of frontal plane movement of his upper body (side to side). Ideally the movement of the head and shoulders should be minimal with side to side motion. This is usually caused by either weakness in the glutes, slow push-off in the forefoot, or some combination of both. I’ve known Caleb for about 7 years and can say that he’s one of the most diligent, hardest workers I’ve met, so watching this pattern is not because he hasn’t done enough side planks or other common core activities to strengthen. The issue rather is that the movement patterns themselves haven’t properly been developed. So, here’s a single leg drill that shows more closely the limited stability in the frontal plane, notice the difference in the right leg versus the left.
As you can see, he’s a little more shaky and slow to load and push-off on the left side compared to the right. Again, when tested individually according to traditional muscle strength testing, his muscles are strong, but when tested in a functional setting, there’s a breakdown in how quickly the load/explode occurs.
So, we need to figure out how to develop that side to side control, which will help him become a more efficient runner and hopefully decrease chances of injury. Here is a video of him running holding an 8# ball overhead, this makes it nearly impossible to have excessive side to side motion with running.
Notice how his core/head stayed more steady, but how much of a struggle it is for his hips and feet. This is a drill I encouraged him to do, with or without weight. Here are a couple other exercises for developing this pattern.
Again, Caleb has a few thousand miles on his legs, with some pretty established patterns, so we don’t see a huge change as far as before and after session, but here is a video of after the session, as well as while holding hands overhead to take away the upper body motion.
You can notice how his legs become more unsteady with hands overhead. Again, he has been relying on his upper body to absorb and rebound a lot of frontal plane forces, so when the hands go overhead, his upper body isn’t able to do this anymore, thus his hips and feet have to figure it out more, this will be a work in progress, but could certainly lead to greater efficiency with running. Good job Caleb!