Running, hip mobility, and the importance of stabilization

One aspect of running gait which has been getting quite a bit of attention lately is the hips, specifically what role they play in sending a person forward.  There are many muscles in the hip, a mobile joint designed to move in the sagittal, frontal, and transverse planes.  The hip and shoulder are designed to function similarly (internally and externally rotate, flex and extend) and the anatomy of the two joints is also similar.  The hip has 6 muscles that function much like the rotator cuff.  The deep 6 muscles of the hip (piriformis, gemellus superior, gemellus inferior, obturator internus, obturator externus, and quadratus femoris) are considered part of the local muscle system, which stabilizes the hip in the femoracetabular joint (Osar, 2012).  The psoas major, minor, pelvic floor, and deep fibers of the gluteus maximus also contribute to hip stabilization, although the deep 6 function primarily to maintain joint centration during rotation.  As we move superficially, the global muscle system, or the muscles that are primarily responsible for movement, can be found.  These include the superficial fibers of the gluteus maximus, gluteus medius, hamstring complex, quadriceps, TFL, adductor complex, and sartorius.  The fibers from the TFL and gluteus maximus joint together to form the IT band, which assists in abduction and internal rotation (Behnke, 2006).  While we consider the hip joint a "mobile" joint, a lot has to happen to maintain stability and throughout movement and gait mechanics.  For instance, if the gluteus medius, which functionally controls hip adduction, isn't firing properly during gait mechanics, the IT band picks up the slack.  This leads to increased knee adduction during running gait and can be a source of knee pain.  In a study performed by Wilson, Kernozek, Arndt, Reznichek, and Straker (2011), the running gait of 20 females without patellofemoral pain (PFP) was compared to the running gait of 20 females with patellofemoral pain (PFP).    EMG analysis revealed gluteus medius activation was delayed and shorter in the PFP group.  Late gluteus medius and maximus onset also correlated to increased hip adduction and internal rotation.  Runners with tight hip flexors have an extremely difficult time extending the hip with a neutral back (Dicharry, 2012).  This not only limits hip mobility, it leads to inhibition of the gluteus maximus which, as seen above can lead to knee instability.

So, what does all of this mean and what can we do about it?  Designing a focused strength and mobility program that emphasizes maintaining knee control during movement in multiple planes and hip mobility while strengthening the hip external rotators and gluteus maximus is a great place to start.  When designing a program, either for yourself or someone, it is important to look at the person's current form during movement, then choose movements to improve function where there is dysfunction, and finally, make sure the movement is executed with quality.  These three things, form, function, and quality, are the pillars of improving moving patterns and enhancing movement function.

Below is a sequence I frequently use to work hip mobility and strength.  If you try it, focus on maintaining proper knee alignment by not letting it collapse.  Also, think about maintaining a neutral spine and letting all of the movement come from the hips.  I usually do 10 per side and switch.  It's a great dynamic primer for more complex movements.

Yours in health and wellness,

Osar, E., (2012).  Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction.  On Target Publications: Santa Cruz.
Behnke, R.S., (2006).  Kinetic Anatomy, Second Edition.  Human Kinetics: Champaign.
Wilson, J.D., Kernozek, T.W., Arndt, R.L., Reznichek, D.A., Straker, S., (2011).  Gluteal muscle activation in females with and without patellofemoral pain syndrome.  Clinical Biomechanics, 26(7), pp. 735-740.
Dicharry, J., (2012).  Anatomy for Runners.  Skyhorse Publishing: New York.