Injuries in Runners / Triathletes : Normal? Part 2: Posture And Strength

Are you strong enough for your sport? How to test it and why posture matters.

A very common phrase among athletes and athletic people is “core strength”.  What does that really mean? Does it mean to have ripped abs and buns of steel? A true definition of core strength is the strength of the underlying muscles of the torso which help determine posture. I like a definition I read recently from a cross-fit site that said it was midline stability during functional movements.

How your body performs when running has more to do with the posture you keep during the day than how strong your abs are or how many crunches you can do .  Your stabilizing muscles that control your form when running actually “turn on” milliseconds before you even start your activity. Athletes that sit all day at a desk or keep poor postural positions run into serious problems that they wont relate to their reocurring injuries. Their spinal stabilizers become inhibited and their muscles fire too late and don’t stabilize when they are needed . So here is the case where you can have a 6 pack and you may be a crossfit king, but if your muscles that are key stabilizers around the spine fire too late, your foundation will not be supported as needed and your body will compensate by having your extremities do the work. This leads to Injury.

In this case an athlete will have injuries ” pop up” in different areas and is forever “chasing pain” by trying to rub it out, stretch it, inject it or medicate it.  Sound familiar? Instead of chasing pain, find the source of the problem. In part 1 in this series we spoke about self mobilizations and how to find those spots before they become a problem.  This blog will focus on evaluating your stability and posture, and will show you some simple tests you can perform to see if you have what it takes to stay injury free. ( click onto link to view pictures of self tests)

Posture:  What postures do you keep most of the day? do you sit at a desk? stand?

If you sit at a desk most of the day, have a college/friend take a side view picture of yourself after you have been sitting awhile and not trying to correct any bad form. You should be sitting on your “sit” bones and not your sacrum. Your hips, shoulders and ears should be in alignment.  Your head should not be way in front of your shoulders.  When sitting, do you cross your legs the same way all the time or sit cross-legged for long periods?   Is your weight more on one hip than the other? Now of course you may slump and change position from time to time.  The rule is 80% in good/better postures and 20% in non ideal postures.  If you stand : Do you typically keep your weight on one leg as a habit?  keeping postures for long amounts of time( greater than 20 minutes) and doing this frequently lead to imbalances that effect your training and performance for the reasons stated in paragraph 2. Becoming more aware of your posture and making these little corrections can be huge! Just take a day and do an internal assessment of what you feel and see in your posture. Awareness is the key!
Do you have an imbalance in strength ? Test yourself

Core Strength pictures Part 2

1) Single leg squats: Stand on one leg and watch yourself in a full length mirror. Keeping your hands on your hips , slowly perform a single leg squat. Does your knee plunge inward? does your trunk shift to one side to keep your balance? Does your pelvis drop and not stay level with the other side, or do you just not have the strength to lower yourself slowly on that leg? These are all signs of an instability and you can be sure that your body will compensate one way or another when you are running. It’s just an injury waiting to happen.
2) Side plank : left vs. Right. Come into a side plank position keeping good form. Hips and shoulders stacked, head in alignment with body and arm perpendicular to the ground. Is one side stronger? – Can you hold one side longer? Can you at least hold for 30 seconds?
3) Bridge with single leg lifts: Lying on your back with your feet hip distance apart and knees bent. Lift your buttock without using your back. Once in a bridge position keep your hips level and bend one knee up towards the chest. (Is this difficult already?) Slowly lift and lower your hips ( remember to keep the hips level) on one leg. You should feel this in your glutes. The goal is 3×10 each side. Notice if one side is stronger than the other .
4) Single leg balance in bare feet: Standing on one leg , get your balance. Can you hold that position for 30 seconds?  Now close your eyes. Can you at least keep your balance for 20 seconds?  Compare it to the other leg. You can easily work on this by standing on one leg at all different times during the day : brushing teeth , doing dishes etc…Get a tennis ball and stand on one foot and throw the ball against the wall and catch it . Or have someone throw the ball to you and challenge your balance.

5) Quadruped single leg lifts: Get into a quadruped ( on hands and knees) position. Make sure your arms and legs are perpendicular to the ground. Place a 3- 4 foot pole across your back to balance it. Keep this pole still and reach one leg back and slightly to the side. Rocking your body or the pole means you are lacking stability. make sure that the leg that is on the ground is perpendicular to the floor. goal is 50 reps for each leg.

These are all simple tests to see if you have any imbalances that can lead to an injury or prevent you from peak performance. If you have found your weaknesses, what do you do? If you try to perform the very tests you failed as exercises you may run the risk of reinforcing poor form because you lack the strength . You must start with exercises that are less challenging and don’t let your body cheat.

This is where an experienced physical therapist that knows how to treat runners can help. A good assessment and video of your running mechanics and functional movements can make the difference in treating the source of your problem or just fixing the pain. Fixing pain is always short-term , which will return in a different place in your body because the real source comes from a compensation that is never where the pain is.

A full evaluation of your posture using an Egoscue approach is imperative to identify the postures that prevent peak performance and lead to injuries. The Egoscue approach looks at posture and functional movement patterns and gives a daily menu of exercises to take you out of your postural dysfunctions.The truth is that we are all getting older and gravity is always working on us . We need specific exercises that counteract all the dysfunctional positions and movements we do throughout the day. This treats the source of all injuries.

Want to take your race results up a notch or just not have all these injuries pop up during training? Take some time to perform these tests and improve your postural awareness.

Happy Training 🙂

Cathy Accurso PT, CKTP, certified Rock Doc

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