The way we exercise and work has changed in the last few generations. Our bodies were designed to be hunter/gatherers. Our very physical make-up enables us to hunt, escape,
harvest and gather by performing an almost unlimited number of movements; walking,
running, throwing, bending, twisting and turning. As the technological revolution has
enveloped our lives, these tasks are no longer necessary and our bodies have begun the
process of de-conditioning in biomechanical terms. Problems arise when we then ask our
bodies to move and perform exercises in this biomechanically de-conditioned state; our
bodies become adept at compensating for fundamental biomechanical issues, like a
rotated pelvis, leg length discrepancies, tight thoracic spines, stiff sciatic nerves and many
others. All of these are significant factors that explain why we can get pain, despite being
‘fit’.
Repetitive motion
There are pros and cons to any sport or activity, but on a balanced scale running is
probably good for us. In fact most exercise is probably good for us, but consider this;
where our muscles were once responsible for performing a variety of different movements
throughout the day, they are now performing repetitive movements when we work on our
laptops or larger repetitive movements when we are out training. The body does not
respond well to repetitive movements; nerves in particular go through a process of deconditioning.
De-conditioning is a mechanical phenomenon where the nature of structures
(in this case nerves) actually changes and as they do, your muscles go into a protective
spasm. Remember, this is while performing exercises, and this consequently does not
allow us to move freely, and ultimately can be another reason for many of us having pain
despite being fit.
Predisposition to injury
As a runner you are predisposed at a number of different levels and below you can see the
loop that runners commonly go through from pain to returning to training (and indeed
working through pain) and back again.
Injury Causation Factors
Age, Somatotype, Previous Injury, Flexibility, Intrinsic Biomechanics
Predisposed individual
Exercise
Exposure
Susceptible
Inciting event
Injury
Rehab
These same principles apply to you too. If you do actually stop for a while to let your injury
settle, even with therapy, you are still predisposed to injury if you are not correcting the
biomechanical problems.
What we need to do is stop the loop by managing the causes on the top of the diagram.
Clearly we can’t change some of them, like age, but you certainly can change your intrinsic
biomechanics. Let’s understand why repetitive movements affect your system, then we’ll
look at how you can identify what is being affected and then what you can do about it.
These are problems that repetitive movements cause that may lead to faulty biomechanics
and therefore injury:
Joint loading.
If a joint is subjected to prolonged pressure when you run, the cartilage begins to lose its
elasticity and therefore becomes vulnerable to damage.
Tension, stress and relaxation
Tendons are visco-elastic in nature which means they can stretch at slow speeds but they
can have trouble moving at high speeds, and the muscles then go into spasm to protect
them. This is not efficient when you are trying to run freely.
Muscle work
High repetition work in your runs can lead to muscle fatigue and in some cases, Delayed
Onset Muscle Soreness (DOMS) and overuse syndromes. DOMS is associated with
increase in muscle tone and the muscle is no longer able to contract and relax properly
which means the muscle is in spasm i.e. it cannot relax. In an individual who does not
regularly train, this chronic state is avoided because we naturally move giving the muscle a
normal sensory input which allows it to relax. However, if we ignore the warning signs and
continue to train, the constant irritation of the now-shortened muscle leads to physical
changes within the muscle, which increases the risk of injury.
Nerve tension
Nerves are visco-elastic in nature, which means that the greater the velocity of stretch
applied to your nerve then the less stretch is available and the greater the stress on the
nerve. This leads to muscle spasm to protect the nerve and does not allow free movement.
So what can you do? To help combat these issues, you can work on a number of areas to
improve your biomechanical efficiency. One important area is your pelvis. If your pelvis is
not working properly, then you have an increased risk of leg, hip and back injuries. A
rotated pelvis is very common and can cause leg length discrepancies, sciatic nerve
tension, hamstring and calf tears, as well as low back and hip pain.
Here is a key check that you can do on yourself to see if your pelvis is working
biomechanically correctly.
The test:
Start:
Sit on a chair or stool and cross one leg over the other.
Test:
Relax your knee down to a conformable position. Look at the height of your knee from the
imaginary line running through your other knee running parallel to the floor. Your knee
should be only 2-3” higher than this line.
Now try the the other leg and see if there is a difference in knee height from the imaginary
line when you compare each side.
Results:
There should be symmetry, with the right side range of movement the same as the left and
both should be the same height from the floor. Also as a guide, the distance from the knee
to the imaginary line should be no greater than 2-3”. If you have asymmetry where one
knee is higher than the other there is an exercise that will help, which we’ll show you later.
Meaning:
If one knee is higher it means that there is a muscle in your hip that is tight or in spasm.
This can limit the movement in your pelvis and in turn can put more pressure on your back,
knees, hips, ankles and shins; often causing pain. Below is a simple exercise to reduce the
spasm in your pelvis and help the pelvis to move again, thereby taking the pressure off
these areas.
The Exercise 4-sign exercise
Technique
1.
Sit on a chair and cross one leg over the other as with the test.
2.
Relax your knee down to a comfortable position
3.
Place both hands on the inside of your knee.
4.
Press your ankle down into your knee by rotating your hip inwards and
simultaneously pull your knee up into your hands.
5.
Press your ankle down at 20% of maximum effort, just enough to engage the
muscles in your hip.
6.
This is a static contraction, so make sure the leg does not move.
Instruction
1.
Hold the contraction for 20 seconds, then relax.
2.
Do 4 sets on each leg.
3.
Do this exercise regularly throughout the day, maybe 4-6 times. Certainly you
should try and do this exercise before and after a run and before and after any period of
inactivity (like watching TV or sitting at a computer or driving).
Notes
If you have identified a problem with your pelvis by it being asymmetrical when doing the
test, try the 4-sign exercise. Make sure you are gentle with it and do not work at it too hard,
otherwise it can be counter-productive. As with any new exercise you may experience
some discomfort afterwards. If it’s low grade muscle ache or stiffness, that is not usually
something to worry about. If its sharper or more severe you may have over done the
exercise so when its settled down, ease off the exercise and be more gentle with your
contraction the next time. If it continues to be painful afterwards, stop the exercise.
If you have discomfort when you adopt the cross legged position, simply lift your knee a
couple of inches higher and that should take the pressure off and be more comfortable. Try
the exercise in that position. There is no advantage in being in pain during the exercise as
it be counter-productive and may aggravate any spasm.
You should find that as you perform the exercise more frequently over the coming weeks,
your knee will fall lower as you cross your leg. This will reduce the load on any structures
that were mentioned before that may be troublesome to you from time to time.
This same exercise principle applies to any muscle. Studies have established that a
muscle relaxes maximally after it has been contracted sub-maximally and for a prolonged
period. So if you think one of your muscles is unduly tight or is not responding to
stretching, try low grade static contractions of that muscle to release the spasm.
A note on posture
Many of you will have fundamental intrinsic biomechanical problems and these need to be
addressed to have a good chance of your posture improving. Even if you work on your
posture, if you do not have the capacity to adopt and maintain good posture, that work is
less likely to be effective. Ensure you have good biomechanical foundations and your
ability to adopt and hold a better posture will be enhanced.
Nerve protection
As runners, we sometimes get confused about what type of stretching we should be doing;
static, ballistic, dynamic, or for some whether to stretch at all. But it has been shown that
mobilising nerves can be very important too; as a tight nerve can cause muscle and joint
injuries. So as part of your warm up and cool down, it’s helpful to mobilise the nerves in
your arms and legs, as well as your normal stretching routine.
So in short try and make sure you are in good biomechanical shape to minimise the risk of
injury. That should include your pelvis as we’ve said, but also your knees, feet, back and
shoulders all need to be checked. If you’re not sure how to do this you can try and find a
local therapist who knows about intrinsic biomechanics.