By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- A biomechanical study shows that the position of the pelvis in running is a potential key cause in overuse running injuries
- Weak hip abductors and glutes are the most common reasons for abnormalities in pelvis position
- Runners with and without overuse injuries would benefit from strengthening the hip abductors and glutes to recover from injury, or lessen the chances of getting an overuse injury
The repetitive nature of running means that runners are unfortunately at risk for a number of overuse running injuries. The most common injuries include patellofemoral pain (PFP), iliotibial band syndrome (ITBS), shin splints or medial tibial stress syndrome (MTSS), Achilles tendonitis (AT), plantar fasciitis, stress fractures, and muscle strains.
A high percentage of runners with these injuries will unfortunately stop running permanently due to the injuries. While there are many factors that may contribute to the development of an overuse injury, a recently published biomechanical study supports the idea that strong hips- especially the hip abductors/glutes- are keys to pain free running.
The researchers performed a biomechanical video analysis comparing a group of injured runners with another group of non-injured runners. They specifically evaluated the runners for position of the pelvis during gait (“contralateral pelvic drop” – CPD), hip adduction, and rear foot eversion. They found that CPD was most strongly correlated to the injured group of runners. And the most likely reason for CPD is weak hip abductors and glutes.
“Contralateral” means the side opposite the injured limb. This means that if you have for instance an issue with your right leg during running, the strength of your hip abductors on your left side may be a strong determinant in why you have developed the injury in the first place.
This is a nice study as it lends further support to the common belief amongst physical therapists, athletic trainers, and clinicians that the hip and glutes are keys to successful running activity. There are some limitations to the study. For example, it is an observational study so we don’t know if the injured group of runners developed a running injury because of the pelvis position, or is the pelvis position a result of their injury?
There are some very reasonable takeaways if you happen to be a runner. First, if you are an uninjured runner don’t neglect the strength of your glutes and hip rotators, especially your hip abductors. Here’s a nice set of simple exercisesusing a resistance band to help strengthen your hips. I especially like the lateral band walk and the monster walk.
Second, if you are an injured runner many of the issues highlighted in the scientific study are correctable. Work with a skilled physical therapist or athletic trainer. They will be able to perform a careful gait and strength analysis, identify areas where you need improvement, and help you put a plan in place to correct these areas.
Keeping your hips strong and flexible will likely make you a much happier runner.