The knees, hips and the lower back are the areas that take the brunt of the impact when we run. All our joints have cartilage on the surfaces of the bones – it’s slippery to allow glide under load, as well as to absorb impact. The knee takes so much load it has evolved a secondary chunk of cartilage, the menisci, to further absorb force. It can be up to five times a person’s body weight when running reasonably quickly. Meanwhile, the bones in the feet and shin are where bone stress is felt most.
The joint and bone tissues adapt to the forces you put through them, so the more you walk and exercise, the stronger the structures are. Likewise, the less you do, the less structured and strong these tissues become. It’s important to understand that it takes bone and joint tissues several months to adapt – far slower than it takes muscles. So if you increase your running or training load too quickly, they can become overloaded and you increase your risk of joint issues, as well as bone-stress injuries.
Try these moves two or three times a week to strengthen the key running joints and bones. At all times, listen to your body and allow recovery time between sessions and runs. Give yourself time – several months to be safe – alongside a graded and progressive running programme.
Inner quad bend
Your inner thigh muscle helps maintain the position of the kneecap. It works primarily between 0 and 30 degrees of your knee bend – the angle you land at when you run. To activate it, stand on one leg with your heel on a book, weight plate or fitness step, with your toes on the floor and the other leg behind you. Bend slowly to 30 degrees, kneecap in line with your toes, then slowly straighten. Do 3 sets of 25 reps. Add weight when this move becomes easy.
IT band foam rolling
Sitting a lot and a lack of flexibility affect how well the kneecap moves. Tightness along the side of the thigh – the iliotibial band – pulls the kneecap outwards and affects how it aligns on top of the thigh bone. Thus, Iliotibial band foam-rolling work is essential – do it for two minutes, twice a day.
LOWER BACK AND HIPS
Lumbar spine rotation stretch
Lie on your back and roll your leg over your body, ensuring you turn the hip fully to the opposite side while keeping your shoulders down. Push your top knee towards the floor with your hand – you will feel a stretch in the back. If you don’t, move your hip further underneath. Hold for two minutes each side.
Hip flexor stretch
Kneel on the leg you will be stretching, with the other leg in front, and that knee at 90 degrees. Next, tuck your tummy in and your bum under you, before pushing forward into a stretch, which should be felt in the front of the hip of the kneeling leg. Hold this position for two minutes. Do on both sides.
The lower back is prone to pain owing to the loss of cushioning in the discs as we age, and/or stiffness from poor posture and core control. Kneel with knees shoulder-width apart, bum near the floor. Tuck your bum under while you lower your head and reach your arms forward. Hold for two minutes.
Lying leg curls
Lie on your back and lift your knees to around 90 degrees. Contract your stomach muscles and roll your pelvis back, lifting the legs up, before returning to start position. Do three sets of 15-20 reps. This has the double effect of mobilising the lower back and strengthening your core. Be careful not to push this if you feel any back pain.
Controlled hops with resistance band
Stand with a resistance band around one knee, the other end fixed to a secure point. Rise onto the tiptoes of the same foot, keeping the hip level and holding the non-weight-bearing hip high. Do small hops; keep the hip high and stable. Make the hops bigger as your control improves. Do three sets of 15-20 reps on each side.
Mark Buckingham is a consultant physiotherapist to British Athletics and runs the Witty, Pask and Buckingham practice in Northampton.
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