Matthew Anderson, MPT
TERRIO Physical Therapy & Fitness, Inc.

It’s May 20^th, 2012 at 7:00 a.m. in downtown Fresno, California.  You are standing with thousands of other runners, eager to start your way on the 13.1 mile trek that you have spent the past several months preparing for.  Before you hear that gun go off you think back on all the hard work that you have put in; all those miles in the cold and the heat, the countless gallons of water you have consumed, the careful attention you have been paying to your nutrition, the time spent mapping running routes, and that amazing feeling you get when you reach a new goal.  It has been a long and difficult journey, but has been one of the most rewarding things you have ever done.  How did you get here, and where did it all start?

My hope is that it starts today, with you reading this article, and starting to build a solid foundation to train on in the next several months.  By the end of this article you will have a better understanding of why it is important to incorporate strength training into your half marathon prep.  I will also give you my top five exercises that you should be doing right now to help keep yourself injury free, and to allow your legs to perform at their best without losing efficiency due to poor transfer of power.

First things first: Why does strengthening matter in running distance?

Running is primarily a saggital plane sport.  What does that mean?  There are various planes of motion that are used to describe movement in the body.  A saggital plane is one that passes from the front to the rear and divides the body into a right and a left segment.  Imagine that there was a plate of glass that divided your leg into two halves and went right through the middle of the knee.  As we run our leg moves forward and back along this plane.  Getting the idea?  So, as we run we primarily engage muscles that make our leg move in this plane.  These are going to be the muscles in the front and back of the thigh, the Quadriceps and Hamstring muscle groups respectively.  Also, we get engagement of the muscles in the calves, the Gastrocnemius and the Soleus, and our hip flexors, primarily the Illiopsoas.  During training these muscles will get strong.  They have to.  All those thousands of repetitions, generating force, and nature takes over and muscular development occurs.  Great!

Here’s the problem.  In nearly all the cases of runners that I have treated in my practice as a Physical Therapist, it isn’t a matter of strength deficiencies in these muscle groups, but in all of the other muscles that help support the leg during running.  As I said above, running is a primarily saggital plane sport.  Mechanically, the body is set up for the leg to swing forward and back along this plane to propel us forward.  When this happens as it is supposed to we are typically running efficiently and at a very low risk for injury.  In order for these precise biomechanical processes to occur correctly, however, demands are placed on several more muscle groups other than those listed above.  We will call these the “stabilizing” muscle groups, because that is what they do primarily; stabilize the leg during both the times when the leg is moving through the air and when it is in contact with the ground.  If these muscles aren’t able to keep the leg stable during the running gait cycle, it is then that mechanical breakdown starts to occur, and typically when injuries happen.  By preemptively strengthening these muscles, you will be at a significantly decreased risk for a training-related, overuse injury to develop.

Let me take a moment to explain why you need to strengthen.  You may feel as though you are strong enough and don’t need to do any “other” exercise than run.  Check this out.  During running a runner’s legs are exposed to vertical forces between 2 and 5 times the weight of the runner’s body. Say you are 150 pounds.  That is between 300 and 750 pounds of force!  Now get this.  If you are running at the suggested rate of 90 steps per minute, and running a 10 minute mile you are taking 900 steps a mile.  So, our 150 pound, 10 minute per mile runner is having to counter act up to 750 pounds of force 900 times each mile.  No wonder he is so tired after his Saturday long runs! 

All kidding aside, I see a lot of runners in the latter portions of their training calendar come in the clinic with injuries that all point back to weakness in the stabilizing musculature of the leg.  It is heartbreaking to hear them talk about all of the work they put in, only to be sidelined weeks before their race.  When explaining why they got injured I stress that they are not weak, but that those muscles were just not prepared to take the tremendous amount of force placed on them during training.  Don’t let this happen to you!

Alright fine, what do I need to do?

 Luckily for all of us who want to go out and run for hours on end and expose our bodies to the extreme forces involved, a little bit of strength training to supplement our run training will make a world of difference when it comes to injury prevention.  I am going to outline several exercises that I feel will give you the most benefit, while keeping it to a manageable time commitment.  So, without further ado, here are the Top Five Running Injury Exercises Your Should Be Doing (it’s a working title): 

1. 80/20 Lunge  http://youtu.be/OBjAoQgv0iI  This is a great exercise that combines many different skills and strengths needed for running.  The primary benefit of this exercise is that it helps build eccentric quad strength, which helps control the knee at impact, and prevents the joint from collapsing under the load  of striking the ground.  This exercise also strengthens the gluteus maximus, which is a stabilizer of the femur when running and also gives strength to the push off motion at the end of the stride. Also, if done in front of a mirror, this exercise helps reinforce correct mechanics of the hip and knee for running.  When performing this exercise, the front leg is doing most of the work and takes 80% of your body weight while the back leg acts only as another point of contact to help with balance.  Remember to sit straight toward the floor with you hips until your front femur is parallel with the ground.  Do not “lunge” forward and let your knee go over your toe, and do not allow the knee to point toward the middle of the body as it should stay aligned directly over the foot. When first performing this exercise it may be helpful to do in front of a full length mirror, and/or with a finger tip for balance on a wall or piece of furniture. Perform 2-3 sets of 20 repetitions for each leg, but only if you can keep good form the whole time. If not, do as many as you can in good form and build up to the recommended 2-3 sets of 20 repetitions.

2. Clamshell http://youtu.be/cH4p31i7PK4  If you think this exercise looks like a Jane Fonda 80s workout video, well, your right!  But, give it a shot before you mock it—talk about butt burners. This exercise is a great way to strengthen the deeper hip stabilizers that will control excessive femoral movement, which can cause the knee and foot to be in less than ideal positions during running gait. To do this exercise, lay on your side with your knees and hips bent with your heels together. Open your top knee toward the ceiling but do not allow movement through your pelvis or low back. If you are new to this exercise start with doing 3 sets of 20, then when this gets easier build to 3 sets of 20 with the added leg lift, finally if this is easy do 3 sets to fatigue—fatigue meaning until it burns too much or when you begin substituting and performing with bad form.

3. Hip Hike http://youtu.be/LuHyOuTfn6I This one looks too basic, but try a few sets of these and you will feel the deep stabilizers this exercise works. We love this exercise because it works muscles that stabilize the pelvis and femur when the foot hits the ground, which is important to keep optimal alignment in the leg. It is a bit tricky to perform at first, because it is an awkward movement, but once you get it you can do it anywhere you can find a step or curb. Remember to keep your standing knee straight, push your standing hip to the side, which will lower the foot that is off the step, then push the standing hip back into your body as if you are trying to make that hip touch your other hip and hold this position for a few seconds. This is the position where the muscle is contracting.  Perform 2-3 sets of 20 repetitions.

4. Bridge and Single Leg Bridge http://youtu.be/cH4p31i7PK4 You can perform this one just about anywhere and it is a great exercise for gluteal and core strengthening, which helps with push off, and to stabilize the femur and pelvis when the foot hits the ground.  With two legs on the floor lift the buttocks off the table, but not so high as to arch the low back. For added difficulty, do this with one leg raised off of the floor. Make sure that your pelvis stays level and doesn’t drop toward the leg that is raised. Perform 3 sets of 20 for double leg bridge or 3 sets of 10-15 for single leg bridge.

5. Eccentric Calf http://youtu.be/WT82rosj7V4 This exercise will give you the rock solid calves that you always dreamed of.  The muscles trained in this exercise will help control your shock absorption at the ankle when landing from a step, and with push off at the foot as you propel yourself forward for the next step. Ideally it is performed on a step or curb, but can also be done on flat ground; you just won’t get the full range of motion. Lift yourself up onto your tip toes with both feet and slowly lower your body weight with one leg until the heel drops past the level of the step. Place both feet back on the step and repeat. Use a wall or piece of furniture for balance so that you can focus on correct form without worrying about balance. Perform 2-3 sets of 10-20 repetitions. 

All of these exercises should be performed pain free (except when you feel the burn) and remember, quality is better than quantity. Don’t try and finish the sets if you are breaking form because this will encourage incorrect movement patterns. Aim to do these exercises 3 days per week, either on non running days, or AFTER a run, not before as you will fatigue the stabilizers that you need to support you in your run.

 Matthew Anderson, MPT is the Clinical Manager for TERRIO Physical Therapy and Fitness in Fresno California as well as a practicing Physical Therapist.  His primary area of practice is sports and orthopedics and has started the Running Lab within the TERRIO Fresno EDGE facility which is dedicated to the treatment of runners using state of the art video gait analysis.  He, along with his wife, started www.painfreerunningsite.com to help prevent injuries that keep runners from reaching their goals.  He is available for contact at manderson@terriotherapy.com or can be called at 559.322.4103.