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The ability to have good hip extension is important in obtaining an efficient running gait. There is a good discussion of this topic on Steve Magness’s Science of Running blog.
The problem that I often see in the age group running community is that their daily activities include:
A – sitting at the computer
B – sitting in the car
C – sitting on the couch
D – running
The first three activities all require sitting which allows the hip flexors to shorten and over time they get tight and lack a full range of motion. This inability of the hip flexors to lengthen properly during the run, limits the ability of the hip to fully extend.
The inability to have full range of optimal movement in the hips is so common among the runners I get to work with and assess that I feel like it is more common than uncommon. This is not isolated to middle-aged runners as I have seen it in younger runners too.
Not only does the lack of normal hip extension lead to less than ideal performances, we see this lead to back pain due to the fact that the iliopsoas originates on T12-L5 vertebrae and inserts on the lessor trochanter of the femur. This means that when it is shortened you can begin to have an excessive lordotic curve of the lumbar spine. This can often be cause for lower back pain.
The common suggestions for correcting the shortened hip flexors is 3 fold:
1. stretch the hip flexors
2. strengthen the hip extensors (glute and hamstrings)
3. use massage / manual therapy or self myofascial release techinques to help lengthen muscle
What about core strength?
An interesting concept is the idea that core strength can play a role with the range of motion of the hip. This concept was put through a test by Janice Moreside and Stuart McGill, with their results published in the May 2012 Journal of Strength and Condition Research. The title of their article is, “Hip Joint Range of Motion Improvements Using Three Different Interventions.”
The article took a group of young males that had limited hip range of motion (ROM) and divided them up into four different groups:
1. stretch only
2. stretch and motor control exercise for the hip and trunk
3. core endurance and motor control exercise
4. control group (no stretch or exercise)
What they found was that two groups displayed improvement in hip extension, hip internal rotation, hip external rotation and total rotation (external + internal). Those two groups were groups one and two (both groups including stretching exercises).
The third group, which had no stretching exercises, did not show improvement in hip extension or external rotation, but did show improvements in internal rotation and total rotation.
What can we take away from this information as runners?
The biggest take away message that I had after reading the research is that stretching is the single biggest factor when wanting to improve the hip flexor’s range of motion to obtain better hip extension. An interesting variable in their study is that they included traditional and myofascial stretches.
The myofascial stretches were done in order to meet this principle:
“A more thorough stretch would be obtained if stretching included not only hip joint motion but also the entire side of the body which was under stretch at the hip, thus incorporating some of the principles of myofascial force transmission (*). For example, stretching of the right hip IR (internal rotation) would also include elevation of the right arm overhead, with extension and left side bending of the torso”
The variable of doing stretches that included this principle was interesting, but was not tested. In any case, the principle is worth investigating further on your own. I’ve listed the resources they referenced below.
What role did the motor control exercises and core exercises have on hip extension?
When looking at the hip extension improvements after the 6 week intervention, the first group had an improvement of 14 degrees of greater ROM, while the second group had an improvement of 10.3 degrees of greater ROM. This shows that both groups had significant improvements in their ROM, but one group didn’t have to spend the time doing the motor control exercises.
Does this mean that motor control exercises are not valuable? Absolutely not, but it is important to always remember your reason for doing something.
What about the core endurance exercises?
There is a lot of discussion about the value of improved “core” strength to improve running performance. A major problem that I see when I look at the information out there on the internet is that “core” means different things to different people and there are a lot of bad ideas out there on how to train the “core”. A tweet that was sent out by well known strength and conditioning coach Vern Gambetta was this:
“Why do we persist in using the term core when it completely undefined? I have fallen into that trap? What is the core? Think before u answer” via twitter
In his book Advances in Functional Training, Michael Boyle says this:
“If we think about the postures of an athletic body or a deconditioned client, we often see excessive anterior tilt. Follow the logic: weak external obliques allow anterior tilt; anterior tilt allows the psoas to shorten; the short psoas inhibits the glutes; the weak glutes and tight psoas prevent hip extension. The result is lumbar extension substituted for hip extension, and subsequently low back or anterior hip pain. … This means core stability is directly related to hip mobility. You can’t separate the two, because if the hips don’t move, the spine will.”
And then when we look at the research from Moreside and McGill referenced above, we see that core endurance exercises helped increase internal and total hip rotation but did not improve hip extension or external rotation.
The entire discussion and excerpts that I’ve shared drives home the point to me that the answer to everything is not “train the core”. It is the popular answer I hear runners sharing all the time to various injuries and run related issues. The larger point that I’m trying to make with this review is to encourage you to have a purpose for what you are doing. Don’t just throw some “core” stuff together and think it’s helping because it is something someone you know does.
Breaking the discussion down into simple “talking points”
It is important to always remember what you are trying achieve. We want to run better.
- To have good running form, we need to have adequate hip extension
- The ability to have good hip extension requires full range of motion in hip flexors
- Assess your running form and your hip range of motion
- IF – you lack adequate hip extension / mobility
- Step One (A): Include stretches that will improve hip mobility. This could include myofascial principles.
- Step One (B): If major lack of mobility exists and you are able to, seek professionals that can use manual therapies to help manipulate tissue and increase movement.
- Step Two: As you increase the mobility of the hips, begin to add back some stability and also consider incorporating some exercises to strengthen hip extension
Running makes us better runners and there are times that paying attention to these kinds of movement issues will allow us to remain healthier and run more.
* Resources from Article on Myofascial Stretching
Huijing, PA. Epimuscular myofascial force transmission: A historical review and implications for new research. International Society of Biomechanics Muybridge Award Lecture, Taipei, 2007. J Biomech 42:9-21,2009.
Huijing, PA and Baan, GC. Myofascial force transmission via extramuscular pathways occurs between antagonistic muscles. Cells Tissues Organs 188: 400-414, 2008.
Maas, H, Jasper, RT, Baan, GC and Huijing, PA. Myofascial force transmission between a single muscle head and adjacent tissues: Length effects of head III of rat EDL. J Appl Physiol 95: 2004-2013, 2003.
Myers, TW. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. New York, NY: Churchill Livingstone, 2001.
Rijkelijkhuizen, JM, Baan, GC, de Haan, A, de Ruiter, CJ, and Huijing, PA. Extramuscular myofascial force transmission for in situ rat medial gastrocnemius and plantaris muscles in progressive stages of dissection. J Exp Biol 208: 129-140, 2005.
Mobility and Stability Resources
Charlie Weingroff – How much mobility before stability (really good article!)
Patrick Ward – Training for Golf Performance Part 2 : Mobility (good concepts for runners to)
Mike Robertson – Mobility and Stability Continuum
Alwyn Cosgrove – Mobility or Stability (Moments of Clarity)
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