When most people think of running, the primary words that come to mind involve the cardiovascular strength end of the spectrum: breathing, endurance, distance, etc. Yes, running is an aerobic sport. To breathe more efficiently and endure longer distances, we must practice the activity that is running. When the title of this blog asks “are you strong enough to run?”, it doesn’t just mean can you move from one place to another, at a pace faster than walking, for a certain amount of time. It is asking can you move from one place to another in efficient, safe manner, a manner that is not susceptible to injury. What many runners (not just beginners), fail to acknowledge is the value of physical strength. Along this spectrum of importance is also mental strength, which is a necessary skill a runner needs to hold themselves accountable.
I used to be one of those runners. I have been running off and on since I was 14 years old, more competitively over the past four years. I have always been good at following a plan (for the most part). I need to use to word “follow” loosely. I would always pride myself on being able to adhere closely to training plans, such as a 12-week half marathon training plan. If a week called for 20 miles, I would make sure those 20 miles were done in a seven day time span, even it meant cramming it all in on the weekend. In the plans I usually follow, two of the days dictate “stretch and strength”. It’s bad enough I would sometimes procrastinate with my mileage assignment. Worse, I would almost always ignore the stretch and strength assignments.
Throughout the years of becoming a more competitive runner, what I started to see in small performance gains also came with slowly increasing overuse injuries: Achilles tendinosis, pes anserine bursitis, proximal hamstring tendinosis, the list sadly goes on. Of all the possible tendons that can be overused with running, I found a way to put an –itis or –osis at the end of each of them. I felt unlucky. Was it my weight? Was it my training plan? Why did I keep getting hurt? As a sports medicine professional, I of course had a multitude of knowledge in treating these injuries, but why would I refuse to do the obvious and prevent them? It all came down to me being stubborn. Wanting to get the “most for my money” and not addressing the strength and mental points on my own spectrum.
That continued to be the case until I began working with other like-minded individuals who were passionate about sports medicine: practitioners who not only treated the injury, but found out the root of the cause. They look at the entire athlete; their entire kinetic chain. Which muscles were tight? Which were weak? Which needed more endurance? Again, working in the sports medicine field, I followed similar principles, but the problem was I never applied them to myself as an athlete.
I quickly learned how weak my hips were. Through reviewing videos and pictures of myself running, I finally saw the big picture. My form was terrible: too much adduction at my hips leading to unnecessary rotation of my legs and knocked knees. A study performed in 2011 by the Running Injury Clinic in Alberta, Canada revealed that runners with patellar knee pain had 28.71% weaker hip abductors than those in the control group. Subsequently, after following a three week hip abductor strengthening program, they reported a 43.10% reduction in knee pain. I would have been a perfect test subject for that study!
So, I finally began to address the strength aspect. It was a key element that was missing from my running plans. I focused on core and abdominal strength, hip, gluteal and hamstring strength among others. I finally used that foam roller than was collecting dust in the corner of my living room. I dedicated my time to not just the physical activity of running. Today, I recover more easily. I have less aches and pains. I keep up my “accountability” exercises as I like to call them. And as a result, I have become a stronger, more confident runner with a lot less aches and pains.
Below I would like to share some important exercises that all runners should become familiar with and try to adapt BEFORE starting a running or training program. Any runner, whether a weekend warrior or competitive elite, can benefit from these exercises. Even if performing these exercises takes away from running itself at first, your body will thank you later!
CORE STRENGTH: keeps the pelvis stable while running and helps keeps proper form after fatigue sets in, thus preventing injury.
- ABDOMINAL BRACING: while lying on your back, tighten your stomach muscles as you draw your navel down. Be sure not to arch your lower back. Start with 30 sets of 5 seconds.
- PLANKS: start in prone position. Then, lift your body up, putting weight through your elbows and forearms as well as the balls of your feet. Start by holding for 30 seconds at a time. Gradually try to increase to 3 sets of 30 seconds. Focus on contracting your core. Try to avoid you lower back from sinking down. Remember to breathe normally.
- SIDE PLANKS: start by lying on your right side. Then, lift your body up, putting weight through you right forearm and outer portion of your right foot. Focus on contracting your core to stay balanced. Start by holding for 15 seconds at a time. Gradually try to increase to3 sets of 15-30 seconds. Repeat the same on the left side. Try to avoid hips from sinking down and try to remain aligned. Remember to breathe normally.
- BIRD DOGS: start in quadruped position with both hands and knees on floor. Then, while maintaining balance, slowly raise right arm followed by left leg, bringing both straight out. Hold for three seconds and slowly lower down. Repeat on the opposite side with left arm and right leg. Start with 3 sets of 10 on each side. Be sure not to arch your back or let your hips sink in.
- BEAR CRAWLS: in the quadruped position, bring the opposite hand and leg forward at the same time while keeping hips level and knees inside of the elbows. Try to prevent lower back from arching. Start by performing 30 seconds at a time. Try to build up to 3 sets of 30 seconds to start
- GLUTE AND HIP STRENGTH: control excessive motions such as adduction and rotation of the legs during running, preventing overcompensation.
- BODY WEIGHT SQUATS: start with feet a bit wider than shoulder width apart. Then, bend knees and sit back as if you are going to sit in a chair. Try to keep knees from caving in. Bend just enough so your knees do not go in front of your toes. Start with 3 sets of 8. Try to advance up to three sets of 12-15.
- LUNGES: start by standing with feet shoulder-width-apart. Next, take a step forward and allow your front knee to bend. Your back knee may bend as well. Then, return to original position, or you may walk and take a step forward and repeat with the other leg. Try to keep knees from caving in. Bend just enough so your knees do not go in front of your toes. Start with 3 sets of 8. Try to advance up to three sets of 12-15.
- CLAM SHELLS: while lying on your side with your knees bent, draw up the top knee while keeping contact of your feet together. Do not let your pelvis roll back during the lifting movement. Start with 3 sets of 8. Try to advance up to three sets of 12-15.
- HIP ABDUCTION: While lying on your side, slowly raise up your top leg to the side. Keep your knee straight and maintain your toes pointed forward the entire time. The bottom leg can be bent to stabilize your body. Start with 3 sets of 8. Try to advance up to three sets of 12-15.
- HIP ABDUCTION WITH EXTENSION AND ROTATION: follow the same progression as hip abduction, but slight extend your hip back and rotate your foot up with toes pointed towards the ceiling. Start with 3 sets of 8. Try to advance up to three sets of 12-15.
- BALANCE: teaches muscles to fire more efficiently on unstable surfaces, thus preventing injury.
- STABLE VS. UNSTABLE SURFACE: practice one legged balancing. Begin on your right leg. Start by balancing on a flat surface. If you need, place a finger or two on a chair or other stable object to assist. Try to start with 15 seconds at a time. Repeat 5 times. Do the same on the left leg. Progress balance difficulty by closing your eyes, adding an unstable surface such as a BOSU ball or foam pad or playing catch with a friend. Try to advance to 30 seconds at a time.
- FOAM ROLLING: to be done before and after running, and days in between. Keeps muscles limber and prevents adhesions from forming which can limit range of motion or cause compensatory movements.
Try to add this workout routine into your training schedule two times per week. If anything causes pain, do not continue, and speak with your athletic trainer or health professional before continuing.
Diana Stavrou, ATC, OTC
Certified Athletic Trainer, RWJBarnabas Health
Dealing with pain and injury is frustrating. You deserve to thrive, and you don’t have to figure it out on your own. RWJ Somerset Physical Therapy is here to provide you with rehab for sport, work, and life, with 6 outpatient Physical Therapy locations - Princeton, Hillsborough, Flemington, Bridgewater, Bedminster, and Somerville. Part of the RWJBarnabas Health family, advanced care is available close to home, making it easier for you and your family to integrate needed therapy into your daily lives. Take your first step towards pain relief and get the help you deserve towards returning to the things you love and have to do. Call us at 855-777-8763! Most major insurance plans accepted.
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