Sunday, August 25, 2013

Trendelenburg Gait

I had an aha! moment today.  I was on facebook and ran across this picture I had posted of myself running at my triathlon last month:
(photo removed)

I immediately noticed how uneven my hips are when I looked at it today. I didn't really notice it before.  I looked at some of the other shots to compare:










(photos removed)









The belt makes it really easy to see, and it clearly goes both ways.  Okay, so it clearly happens, but does it matter?  Maybe that's how everybody runs?  Maybe it's normal?  So I googled, and I quote: "should your hips be level when you run".

Turns out the answer is yes.  "Hip drop" while running, also called "Trendelenburg gait" is a sign of hip stabilizer and abductor dysfunction and/or weakness, and is a common contributor to IT band syndrome.  Hmm.  Who do you know who has been fighting that for the past SEVEN MONTHS??

My running photos look just like B, right!!  (B is Bad!)  Photo and lots of good info from : RunnersConnect.net.  To be fair, you can only do this analysis during the "stance" phase of the gait, and none of my pictures above are really in the stance phase exactly, but given my failure on two tests (described below), I'm going to say it's a legitimate issue for me.
The way to fix this is through hip abductor and gluteus medius strengthening (which I've already been doing), and focusing on correcting/preventing the drop in your gait.  The problem is that you can have strong hip stabilizers but still experience the drop if they are misfiring during your stride.  Read about the whole thing in more detail at RunnersConnect.net.  

While I was reading, I came across a link to another article about tests you can do to assess whether your hip stabilizers are functioning optimally.  I didn't have to do the two tests to know that I FAIL on both counts, because I have noticed the failure criteria in the past when I was doing the exercises, even though I didn't know what it meant at the time!

The first is a single leg glute bridge, which I have been doing every time I do strength work.  The test is to do a normal glute bridge, then lift one leg, and see if your hips stay level; then repeat on the other side.
Photo from http://runnersconnect.net/running-injury-prevention/hip-strength-and-stability/
I had already noticed a severe dip in each hip whenever I lift the ipsilateral leg during this exercise.  I had already been trying to minimize it, as it seemed like it probably wasn't "right", even though I didn't really have any facts or instruction about it.  It still dips, but when I really focus on it I can reduce it a little.  So yeah, I'll keep working on that.

The second is a pistol squat, again, that I have already been doing.  The test is to watch your working knee, and whether there is movement during the squat.
Photo again from http://runnersconnect.net/running-injury-prevention/hip-strength-and-stability/
They are really hard, so I use a suspension trainer to help out a bit, but in doing them probably two months ago, I noticed that my right knee especially tended to wobble inward when I squatted.  I meant to ask the PT about that but never got around to it.  I even sometimes notice a little inward wobble with my right knee (my bad knee) during a single leg press.

I ran 4 miles yesterday. I needed my IT band strap but it was pretty much pain-free.  The thing is that I'm super conscious of my knee now and a little paranoid.  The level of discomfort I'm at right now probably wouldn't have caused me to take any time off at all last year, and it's SO MUCH better than it was a few months ago, but I'm hyper sensitive to it now and afraid to push my luck at all.  Any lingering pain the day after a run sends me to the bench in fear.  I'm still registered for the Woodstock half marathon in 13 days, even though I'll be nowhere near half marathon distance by then.  I'm thinking of dropping to the 5 miler.  If I do the half, it will be at 4 min run intervals with 1 min walk breaks.  Or maybe even more walking than that.  I'll email them to find out how much it costs to change races.  Luckily, the 5 mile still gets a cool peace sign finisher's medal, so that's nice!


I guess I'll keep on keepin' on in the meantime.  Gotta keep focusing on those stupid hips!

Haha, this reminded me of that scene from Happy Gilmore.  "It's all in the hips..." (see video clip below):

(If you're in the same boat as me, you can download some good hip strengthening exercises here: Hip strengthening exercises for runners.)

1 comment:

  1. Thanks for sharing the hip exercises. I think I need to work on doing more myself. I started going to a chiropractor at the beginning of the year, and x-rays showed that my hips were clearly out of alignment. I thought I'd give it a shot to see if it helped my shin problems. After several months, new x-rays showed that my hips were lined up. My shin pain has dropped off quite a bit (though they're still not 100%) and I'm sure the hips must have had something to do with it. I'm sure I have form or some other issues on top of it though. Of course paying for a chiropractor is not fun, so it's definitely worth giving the exercises a try. I'm curious to hear how it works for you.

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