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 de-conditioning. 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
What we need to do is stop the loop by managing the causes on the top of the diagram. Cleary 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 as shown in the diagram;
Test:
Relax your knee down to a confrotable 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, or you could click here to find a biomechanics coach or screen yourself on this revolutionary new self-screening and exercise prescription programme called iMoveFreely.com.
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