Hip Hip Hooray

Giving your hips some love and attention will make you a more powerful runner and future-proof you against injury by Lisa Buckingham for Women’s Running Jan ’19 issue

Your hips and pelvis work together as the foundation for your spine above and for the legs beneath them, and the muscles, ligaments and tendons surrounding them play a hugely important role for runners.

This includes the hip flexors that run down the front of the hip, which lift the knee and bring your thigh upwards during the swing phase, but also muscles that you wouldn’t necessarily associate with your hips. These are the quadriceps, which insert into the hips, and the gluteal muscles in your buttocks – gluteus minimus, medius and maximus – which help keep your hips and pelvis level as you run.

When you run, your hips have to work much harder compared to when you’re just walking. This is because your weight is only ever on one leg at a time (this is known as the stance phase). “Along with the powerful forward drive of running, your hips provide all of the support during the stance phase,” says Rachel McCulloch ,consultant rehab physiotherapist at Six Physio (sixphysio.com)

Injury hot spot

Put simply, if they’re not working properly, it can increase your risk of injury – and not just in the hip. A recent study in the American Journal of Sports Medicine showed that contralateral pelvic drop (CPD) was the strongest predictor for soft-tissue running injuries in the leg, such as iliotibial band syndrome, Achilles tendinopathy and patellofemoral pain. The study found that for every 1° increase in pelvic drop, there was an 80 per cent increase in the odds of the runner being classified as injured.

CPD happens when you don’t keep your pelvis and hips level as you run and it’s also known as the Trendelenberg gait. As you land on one foot, your weight-bearing hip pops out to the side, and the opposite hip drops down. Google a video of someone doing it and you’ll recognise it instantly as so many runners are guilty of doing this.

“I see it in about three quarters of the runners in my clinic,” says Rachel. “It can increase risk of injury because it creates unnatural planes of movement further down the leg. For example, the sideways movement of pelvic drop can create a diagonal movement in the knees, which are not equipped to deal with this. Your ankles, feet and lower back can also be affected.

“Dysfunctional hip movement also reduces running economy, which means that the effort you’re putting in is not equalled by your output.”

Build hip strength

To check if you’re prone to CPD, ask a friend to video you running from behind – wear close-fitting, bright clothes so that you can see your body shape. Then check online videos for reference when you review the footage. Whether you need to correct CPD or not, there’s plenty you can do to improve strength and stability around your hips and pelvis and become a faster, less injury-prone runner:

• Target your glutes. “Consider your glutes as a whole: while some might be strong if you do exercises such as squats, you need to make sure they’re all strong. During the stance phase, the gluteus medius works to keep your hips level.”
• Take up Pilates. Equally, you can be strong in the glutes, but have other biomechanical issues that affect your hips. “The most common are tight hip flexors and quadriceps, creating an anterior tilt in the pelvis and leaving the glutes struggling to function; lack of control in the lower abs, and inflexibility in the thoracic (mid) spine,” says Rachel. “Compliment running with Pilates, which will focus on flexibility, strength and control.”
• Raise your cadence. A low cadence (the number of steps you take per minute) can be a key predictor of pelvic drop. “The fewer steps you’re taking, the more likely you are to be dropping your hips,” says Rachel. “The ideal is between 170 and 190. Introduce a higher cadence by doing it just one minute during a run, then increase gradually.”
• Ditch the scissoring. Another common cause of CPD is a scissoring gait, where your feet are landing as though you’re on a tightrope. “This disadvantages the glutes,” says Rachel. “To help correct it, imagine a straight line out in front of you and run with your feet on either side of that line.”