Prevent Injury
The following five exercises and two stretches are our top picks as a foundational, proactive approach to injury prevention (prehab), whether you have experienced a past injury or not. While standard rep ranges are provided, go to a point that is comfortable for you.
EXERCISES:
1. Bulgarian Split Squats
Reduces Risk for:
– Patella Femoral Syndrome (Runner’s Knee)
– Patella Tendonitis
Purpose: Increase load on the knee cap. This load, done gradually, increases the cartilage’s ability to withstand increased stress. Cartilage can adapt with weight training/loading exercises; it just takes some time as there is a minimal blood supply to the area. Given that knee injuries account for about 50% of all running related injuries, this exercise is invaluable to keep your knees strong during your runs! The muscles that are primarily stressed are the quads and glutes.
Instructions: 3 x 6-8 reps (Heavy Squats*), 2-3x/Week (slowly, 3 second down, 3 second up) – In a split squat stance with your back leg supported on a chair, come straight down then back up. You can use a pole or chair to support your balance. *Heavy squats means “more weight” or “heavier loads”, which optimize tissue adaptations.
2. Calf Raises
Reduces Risk for:
– Calf Strains
– Achilles Tendonitis/osis
– Plantar Fasciitis
– Patella Femoral Syndrome (Runner’s Knee)
Purpose: Help load the gastrocnemius and soleus (calf) and Achilles tendon. This loading will improve the loading capacity of the tissue, thereby improving its tolerance to stress during runs. If the calf is weaker, the knee flexion is prone to increase, causing more compression stress on the knee. Improving your calf strength will also improve your ankle stability, which will also decrease the demands on the plantar fascia.
Instructions: 3 x 12-16 reps (Toes Raised Up), slowly, 2-3x/Week – Place a small rolled-up towel under your toes. With your feet shoulder-width apart, begin by coming up on your toes with your knees straight throughout the entire motion. You should feel the muscles in the back of your calf working.
3. Double Leg Glute Bridge
Reduces Risk for:
– IT Band Syndrome
– Patella Femoral Syndrome (Runner’s Knee)
– Patella Tendonitis
– Lower Back Pain
Purpose: Helps improve strength and stability in your hips. Your hips are important in stabilizing the knee when you land. When your glutes do not fire appropriately, you may notice your knee caving in or that you have an excessively upright posture to compensate for the lack of glute strength. Furthermore, you may see excessive lateral sway when one foot strikes if the hip abductors are unable to stabilize the body. The primary muscles involved in this exercise are the glute rotators and gluteus maximus.
Instructions: 3 x 12-16 reps (with Band), Daily – On your back with your knees bent and a Resistance Band around your knees, bring your hips up by engaging your glutes and pushing your knees apart for more glute recruitment. It may help your lower back to maintain a posterior pelvic tilt. Hold your hips in the air for 5 seconds, keeping knees apart in the band, then come back down. You should feel muscle activation primarily in the glutes, with the quads, hamstrings, and back muscles helping.
4. Front Planks
Reduces Risk for:
– Lower Back Pain
Purpose: Your abdominal muscles help support your spine against impact loads while running. Training your core muscles, such as the transverse abdominus, multifidi, and obliques, is imperative to a healthy, pain free lower back. Without the support of these muscles, there are more shearing forces in the spine that can cause discomfort and strain when you run. Runners may experience progressively dull back pain when running if the core is not strong enough to withstand forces when running.
Instructions: 3 x 45 seconds (or best you can), 2-3x/Week – Come up on your toes and elbows, with your elbows directly below your shoulders. Bring yourself up into a plank position, keeping your body level the whole time. If this is too easy then you can bring your hands father away from your chest or add more time. Make sure to keep your back level and avoid dropping your hips. You should feel muscle activation in your front abdominals and in your shoulders.
5. Arch Exercise
Reduces Risk for:
– Shin Splints
– Plantar Fasciitis
Purpose: Improve your arch posture and tissue strength to absorb the impact forces of foot strikes while stabilizing your foot and shin muscles.
Instructions: 2-3 x 10 seconds (3 Parts), 3x/Week – Think of your sole as having three key points of contact with the ground: two points on the ball of the foot and one at the heel. Stand with your feet shoulder-width apart and lift up all your toes. Hold that position for 10 seconds, maintaining the three-point anchor and a stable curved arch. Next, still maintaining the sole’s 3-point connection to the ground, lift up your big toes while keeping the little toes down for 10 seconds. Finally, bring your big toes down with little toes up, watching that your foot does not rotate inward, collapsing your ankle. Hold that for 10 seconds. If difficult, you may have to train your toes by positioning them with your hands.
STRETCHES:
Complete the following daily. Research shows that 90 seconds is good (3 x 30 seconds), though there is plenty of room for adjustment. Sometimes the biggest benefit comes from prolonged hold times at 50% stretch.
1. Ankle Dorsiflexion Stretch
Reduces Risk for:
– Achilles Tendonitis
– Plantar Fasciitis
– Lower Back Pain
– Patella Femoral Syndrome (Runner’s Knee)
Purpose: Address restrictions in the ankle; if ankle dorsiflexion mobility is limited, notable compensations may occur, causing increased stress at the foot, ankle, knee, and back. If you have ankle mobility restrictions, you might see your toes begin to point outward as your leg trails behind you. The primary joint involved is the talo crural joint (ankle joint).
Instructions: In a kneeling position, bring your knee forward over your ankle and hold while keeping your heel on the ground. If you want a greater stretch, you can bias your knee inward and outward to increase ankle joint mobility.
2. Kneeling Hip Flexor Stretch
Reduces Risk for:
– Lower Back Pain
Purpose: Improving hip extension. The motion of the hip flexor is vital to achieving appropriate stride length when you run. Because most of us sit for prolonged periods of time, the hip flexor muscle can adaptively shorten, thereby decreasing the length of the muscle into extension. As a result, runner’s sometimes compensate with excessive lumbar extension to achieve the movement. The primary joint involved is the femoroacetabular joint (hip joint).
Instructions: In the kneeling position with your arms supported on the wall, engage your abdominals by doing a posterior pelvic tilt (i.e. Lower Back is flattened with a limited curve). Engage your glutes on your kneeling side and keep your body as a unit until you feel a stretch in the front of your hip. You may increase your stretch by leaning away from the side.