Core Series: Hamstrings

Hamstrings…not exactly the muscle group you think of when someone says “core”, amiright?

  1. Biceps femoris
  2. Semitendonosus
  3. Semimembranosus
The problem children of runners the world over.

The problem children of runners the world over.

I kept that picture HUGE so you can see all the little details. See how the hamstrings attach to the bottom of the pelvis (called the ischial tuberosity–please STOP CALLING IT A SITS/SITZ BONE) and then shares an attachment site with the sacrotuberus ligament that attaches to the sacrum?

Here’s the point: tight hamstrings are more than just a pain in the leg. Tight hamstrings can pull your pelvis downward, causing a posterior pelvic tilt. What does that mean? Low back pain and asymmetry. Remember my 3 S’s? Strength, stability, symmetry. Asymmetrical –> injury.

So, tight RIGHT hamstring can also put too much stretch on the RIGHT hip flexor, causing a tension reaction (also can indicate a weak RIGHT hip flexor) and mess up your gait when you walk and run. It’s also just painful.

How to strengthen it?

You can do basic hamstring curls, but that’s not very practical in everyday use. My favorite exercise: Physioball Roll-ins.

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The key part of this exercise is to lift your butt and KEEP YOUR HIPS AT THAT HEIGHT while you bend your knees inward. If your hips go up or down, you lose the exercise completely.

It’s hard, I know. If it’s too easy for you, check your form. The strongest of athletes can’t do this exercise without wobbling.

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For those of you who need a less strenuous hamstring exercise, there’s the Standing Leg Curl. They key part of this exercise is to make sure your bending knee’s hip doesn’t dip as you lift your foot. Standing against a wall or a table will assure your hips stay level when you do it.

Most importantly, SUCK YOUR BELLY BUTTON IN and stick your chest up and out to activate your other core muscles.

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You can add an ankle weight or a Theraband with cuffs when you get stronger.

In order to perform these exercises and get a benefit from them, I recommend starting with only a few reps (2-6) for 3 sets. Only do as many reps as you can maintain perfect form. Stop as soon as your form goes. Rest. Try again after a full minute.

Now go out and run!

Are You Strength Training the Right Way?

Winter running season is also known as off-season for most of us. We take a break from the heavy mileage, as least for a few weeks/months, and hit the weights and our favorite cross-training workouts.

Snow thanks, I'll spin.

Snow thanks, I’ll spin.

And hitting the weights should be your TOP priority during the off season. But are you doing it right?

I’m sore for 3 or 4 days after I lift. That’s good, right?

Wrong. Wrong, wrong, wrong, wrong. Stop that right now. Soreness is due to microtears in the muscle fibers due to challenging the muscle either with more weight or a different movement. This is normally a good thing that allows for growth of the muscle. BUUUUUUUT, when normal soreness is 24-48 hours. After that, it’s not soreness, it’s muscular necrosis (dead tissue).

The danger of doing this? Rhabdomyolysis, which is basically poisoning your kidneys with the chemicals your dying tissue releases. Can permanently damage your kidneys and put you in the ICU.

DANGER Will Robinson.

Challenging your body is good, just don’t go overboard.

I strength train once a week. That’s enough.

No, it’s not. I’ve discussed de-training here before but it had more to do with aerobic capacity. Power and strength are a little different, but the bottom line is you need to strength train every 3-4 days (2-3 times/week) to make and maintain strength gains. Otherwise, it’s a brand new to your muscles every week.

Weights are your friend. Get to know them.

Weights are your friend. Get to know them.

I don’t lift heavy weights because it’s going to make me bulk up.

I can’t even with this. Every health and fitness magazine in the world has an article of why this isn’t true. I don’t need to belabor the point. It’s just true, ok?

I run. I don’t need to lift. Running makes my legs strong.

…said every runner who then ended up with an injury due to strength defects. Look, it’s all about strength, symmetry, and stability. Long distance running does not promote any of these things because it’s unidirectional and repetitive. Sprinting or hill workouts can definitely help, but you have to do them right.

Don't be this guy (Image courtesy of vector.rs)

Get strong before you go long.
(Image courtesy of vector.rs)

Focused, functional movements on multiple planes with challenging weights is how you get stronger.

I hope this helps as you head into your off season!

Now go out and run.

No Goal Running

Holy smokes, you guys. I gotta give a shout out to Theodora over at Daily Burn for the amazing mention in her article yesterday. I don’t even know what to say. I’m honored.

Welcome to the off-season of running. With the exception of CIM, I don’t think there are many other large marathons happening for a while. Hallelujah.

Hip-hip HOORAY for off season!!!!

Hip-hip HOORAY for off season!!!!

I realize that not all of you love off-season. I agree that it can be difficult to get motivated to run when there’s not a specific goal in the upcoming months to work toward. It’s not easy.

Buuuuuuuuut, there are lots of things to do that will prepare you for NEXT YEAR’s race. Read on.

  1. Get that nagging pain checked out and addressed.
  2. Get in better shape. Not running shape, better shape.
  3. Work on weight loss. If this something you feel you need to do, this is the time.
  4. Get stronger. Every one of you needs to do this RIGHT NOW.
  5. Work on speed.

It may be hard to believe, but the work that you put in NOW is going to determine how those 12 weeks of marathon training next Spring or Fall will go. Really.

So, yeah, go for runs. Have some fun. Play in the snow (or, if you’re in NYC today, the pouring frickin rain) and run the shorter distances (10 miles or less) until your training season ramps up next year.

Get strong before you go long.

Me? I'm Refine-ing to get stronger! Apparently, great minds think alike over at Refine Method. (Image shamelessly stolen from Brynn)

Me? I’m Refine-ing to get stronger! Apparently, great minds think alike over at Refine Method.
(Image shamelessly stolen from Brynn)

I should trademark that. But seriously, get strong now. Work on those weak areas now. Get into the gym and get to know your friendly physical therapist. Cuz off season has its place, too!

Now go out and run.

CrossFit and Running

This post has been gestating for a while, ever since I created a training schedule for my friend Tina’s Hat Trick. Tina is a big time CrossFitter but also an experienced runner. My challenge was to keep CrossFit in her life while she trains for a 5K and a 10K on the SAME DAY and then a half-marathon the VERY NEXT DAY.

Yowza.

(Halfway) Dr. Abby is on the case!

(Halfway) Dr. Abby is on the case!

The flood of emails that followed from my popular friend’s blog posting about her new schedule were predominantly about how to train for a marathon while still being able to do CrossFit. Some were CrossFit-like HIIT workouts, but the majority were people going to actual CrossFit boxes (this is what they call their gyms).

Disclaimer: I do not condone nor was I compensated by CrossFit or any CrossFit affiliates. This is NOT an article supporting or encouraging the use CrossFit in any fitness program, but rather a “How To” guide for marathon training for those who don’t want to exclude it from their schedule.

Probably. (Image courtesy of AnderToons.com)

Probably.
(Image courtesy of AnderToons.com)

There are a couple of rules of thumb that you will just have to deal with during training if you want to get the most out of your running program.

  1. Put your running first.
  2. Scale back your heavy lifting to 2 days per week in order to get the most out of your run workouts.
  3. During peak running season, don’t increase the weight on your strength workouts.
  4. Get more rest. No really, get MUCH more rest.
  5. Schedule your lifting days appropriately in your running schedule.

With each of my CrossFit runners, they learned #1 the hard way. They didn’t want to switch up the WODs (Workout Of the Day) for their runs and thought they could do it all and see results in running.

Thing is, it’s no my opinion that they need to prioritize running in order to see running results. It’s science.

One specific type of muscle fiber develops during maximum lift training. Another completely different type of fiber develops during endurance training. They don’t exactly play nice together. There are a few other in-betweenys but those two are the biggies who rule the schoolyard.

Only one can win.

Only one can win.

So, when you think about mixing marathon training with CrossFit, get your priorities lined up. What’s important? Running a great race? Continuing to rock your CrossFit WODs? Setting a personal best in the 26.2? Putting up more weight on your deadlifts?

It’s all about what your personal goals are. You can do both, but in the end, one really has to be the focus. Set the other one on the back burner and put it on low heat during high training.

Now go out and run.

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IT Band Research

A few weeks ago, I had to write a short paper about a common lower limb injury and provide the mechanism for injury, muscles involved, treatment, and rehabilitation for the injury.

Below is the paper with the scientific resources to back up the paper. These resources came exclusively from peer-reviewed articles. So, if you were interested in knowing more about your favorite lateral fascia, here you go! It’s science.

(Image courtesy of Anaerobic.net)

(Image courtesy of Anaerobic.net)

(If you copy or quote any portion of this paper, you must cite me as a source and/or the sources cited within the paper and notated below)

Illiotibial band syndrome

By Abigail Bales

Illiotibial band syndrome (ITBS) is responsible for approximately 22% of lower extremity injuries.(5) It is especially prevelant in the growing number of both professional and amateur long-distance runners due to repetitive nature of the movement of the knee, specifically the flexion of the knee.(3) It is the most common lower-limb injury in long-distance runners. The illiotibial band is a thick fascia that extends from the muscle fibers of the gluteus maximus and medius as well as the tensor of fascia latae, over the lateral femoral condyle of the knee, and attaching to the infracondylar tubercle of the tibia.(2) The causes of the injury are multi-faceted, though most recent studies focus on hip adduction, knee internal rotation, hip flexion, and overall kinematics of the individual. Training factors and terrain can also contribute to cases of ITBS. All, in part, seem to be to blame. This suggests that weak hip abductors and glutes, improper form, and speed of the movement are the root causes of the injury.(1,3)

Athletes experiencing ITBS often complain of knee pain located near and around the lateral condyle of the femur and/or hip pain localized near or around the greater trochanter of the affected leg. In mild cases of ITBS, symptoms may come and go during various activities, dissipate during exercise, and become aggravated on certain terrains or during rest.(4) In its most severe form, many athletes will find the pain so severe that they are unable to participate in running or cycling activities entirely.

Surgery is rarely necessary and is not recommended as a treatment for ITBS. Common treatments include rest, reevaluation of training and mileage, strengthening exercises, stretching, and myofascial release techniques. There are conflicting theories about the role played by the hip abductors, and subsequent strengthening of them, in ITBS. While studies point more to over all body mechanics and running form as the root cause of the syndrome, including over-adduction of the hip, hip abductor strengthening is routinely part of the rehabilitative process prescribed by physical therapists.(1)

Dr. Michael Fredericson, a professor at Stanford University who has done extensive research on ITBS, found in his 2000 study that, “Long distance runners with ITBS have weaker hip abduction strength in the affected leg compared with their unaffected leg and unaffected long-distance runners” and found that “after 6 weeks of rehabilitation, 22 of 24 athletes were pain free with all exercises and able to return to running, and at 6-months follow-up there were no reports of recurrence.”(2) This study focused on improving gluteus medius and minimus strength (hip abductors) and stretching as a treatment for ITBS in males and females from the Stanford University Cross-Country and Track teams.

The literature calls for abductor strengthening exercises, such as side-lying lateral leg raises with ankle weights, side-stepping straight leg walking with resistance bands, in addition to foam rolling, stretching, and massage as the best and most common forms of treatment for ITBS. In addition to treatment, complete rest from hip flexion activities would be prescribed, with return to small amounts of activity over time, so long as symptoms did not return.(2) Gait analysis and speed of running are also to be considered as a part of the rehabilitation and preventative process since ITBS occurs less in faster runners,(3) presumably because their form is better than that of slower runners.

References

1. Ferber, Reed, PhD, CAT(C), ATC, et. al. Competitive female runners with a history of iliotibial band syndrome demonstrate atypical hip and knee kinematics. Journal of Orthopaedic and Sports Physical Therapy. February 2010. Vol 40 No. 2. 52-58.

2. Fredericson, Michael, M.D., et al. Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sports Medicine. July 2000. Vol 3. 169-175. PMID: 10959926. http://www.ncbi.nlm.nih.gov/pubmed/10959926

3. Fredericson, Michael, M.D. Illiotibial band syndrome in runners: innovations in treatment. Sports Medicine. 2005. Vol 5. 451-459. PMID: 15896092. http://www.ncbi.nlm.nih.gov/pubmed/15896092

4. Khaund, Razib M.D. Flynn, Sharon H., M.D. Iliotibial Band Syndrome: A Common Source of Knee Pain. American Family Physician. April 2005. Vol 8.1545-1550.

5. Linenger JMCC. Is iliotibial band syndrome overlooked? Physicians and Sports Medicine. 1992. Vol 20. 98–108.

Now go out and run!