The marathon must be close…..
One of the perks of my job is that I am able to see a lot of people who are training for the Boston Marathon. Fortunately the owner of the practice I work for is friends with one of the coaches for a local business with a high number of participants. Unfortunately, it seems that a lot of people who are able to get access to numbers for the marathon are not runner’s prior to participating in the marathon. This week alone I saw about 4 people with marathon training injuries. I would have seen more if we had more openings to fit in all the people that called the office. This is a month before the actual marathon, and it is also the part of the training where participants are starting their long runs.
As a result, people’s bodies and joints are starting to fail under all this stress. These people have not readied their bodies for running. They started to run, with no effort into strengthening their muscles. And since they were not runner’s to start with, the body does not know what to do with the added abuse.
This is really unfortunate, because there are some steps that can be taken to prevent injury. What is the number one issue I find with runner’s who come in to see me? Weak hips pure and simple. This isn’t even close. They have what I like to call sleepy glutes. I test this mainly with a single leg bridge. Also, when testing the gluteus medius, most people cannot even lift their legs against gravity, how could they possibly be expected to take the abuse of running 20+miles.
Here are the main beginner treatments I have for this:
1. Hip flexor stretch: 
As stated above, a lot of my patients aren’t lifelong runners, they are mainly office workers doing the Boston Marathon for fun or for a challenge/bucket list accomplishment/etc. Needless-to-say, these people do a lot of sitting, and typically have extremely tight hip flexors. If these are tight, they can work to “switch-off” the glutes, so this is where I usually start.
2. Double leg glute bridge: 
Think of this more as a motor activation exercise as opposed to a pure muscle strengthening. I give people the cue of squeezing their bottom together so as to avoid overuse of lumbar extensors.
3. Single leg glute bridge: 
Running is a single stance sport, therefore you need single leg glute activation.
4. Clamshells: 
Again a motor activation exercise that helps recruit the hip external rotators or hip abductors
5. Prone bridge: 
If patient can exhibit proper form of course
6. Side bridge with side leg lift: 
Again, if the patient is able to fully lift leg against gravity
7. Glute med walk: 
As you know, running is a closed chain activity, done in an upright position.
These are just a few of things I will have a runner start with to improve glute activation. Also keep in mind that weak hips are not the only issue that could be present, so this is not for everyone. This post also doesn’t get into the topic of these people should be doing a marathon in the first place, but that’s another post.
Any other thoughts?
(sorry about the pictures of me, but I don’t want to get sued)
