Injury prevention, July 08, 2020
This is my first article in the Trail Runners Magazine. All about the importance of having strong, stable hips.
Stable, strong, and mobile hips underpin efficient running form and a healthy functional life.
As we age our hips start to seize contributing to a shortened stride. This results in extra torsional stress placed on the areas above and below the hips - the lower back and the knees. I hear so many people state they had to give running away due to “sore knees” when in fact the main contributing factor is poor maintenance of hip range, strength, and stability. This doesn't happen overnight, it's a negative spiral of losing strength, and range resulting in poor compensatory movement patterns that happens over a lifetime.
In my experience as a physiotherapist, running coach, and lifelong runner I have found that the way we live our lives has far more power over hip health than other more widely marketed methods. Running form, stretching, and gym strengthening work have their place, but if you don't work on the poor daily habits with the way our society is living, these reductionist practices will never halt the advancing tissue shortening and weakening. It may slow it down, but the tidal wave of poor function will still overwhelm the small reductionist resistance. One of the biggest contributors to poor hips is the invention of the chair. When you sit for more than 2-3 hrs a day it contributes to shortening of the hips, poor blood supply to the biggest muscle group in the body (the gluts), and gradual shearing load throughout the lumbar discs. From an early age we need to teach our children to stand more, move more, look at collaborative learning techniques standing around a high bench or lying under a tree rather than being restrained in a seated position. I can remember looking at studies back in my University days showing cultures having less hip osteoarthritis due to less sitting time, more squatting, and more movement throughout their days. The Beijing OA (Osteoarthritis) study published in the Arthritis & Rheumatism Journal (Vol. 46, No. 7, July 2002) showed that the elderly in China had 80-90% less occurrence of hip OA compared to a similar age match group in the USA.
Many of us spend far too much time in cars. When sitting in a car you tend to have your knee's higher than the hips - the hips are in an even more shortened position than if you were sitting at a desk. If you commute to work using a car, then sit for most of the day, commute home, plus sit to eat dinner and for a little screen time afterwards to relax then the amount of sitting adds up and snowballs week after week into chronic hip issues (increased sitting is also linked to a wide range of wellness concerns). Some small habit shifts to stop then reverse the rot are using a cycle to commute to work, putting in lunch time brisk walks, and using a standing desk. Some European countries have done very well with promotion of cycle friendly cycle paths, and in Denmark it is illegal for an employer not to offer an employee a standing desk option.
Some other habits that I have found useful to encourage more healthy hips is swimming, scooting, and yoga.
With swimming (I recommend swimming to most of my running athletes) it is very beneficial to mix up the strokes allowing the hips to move through increased range with the hydro pressure of the water as resistance. Our swim crew always has drills, breaststroke, and some butterfly to really encourage complete muscle activation around the hips, and full body core engagement. Swimming is one of the most underutilised therapeutic interventions for runners, plus studies have demonstrated the longevity benefits of swimming. One Long term study out of Indiana University found that masters swimmers that swam 3-5 week postponed the aging process for decades according to traditional age markers like muscle mass, blood pressure and lung function.
When I go to pick up Stella from primary school I either cycle or use my other daughters scooter. It's a fantastic micro workout with hip stability work on the stance side and glut/Hamstring ballistic activation on the push side. I like to imagine the exploding push off and try to get my heel nice and high before I follow through for the next push. I would love to see more parents on cycles and scooters collecting their kids from school rather than clogging the roads (and our lungs with the emissions) with cars. I've also found my girls tend to be more communicative with the active mode of transport than when sitting in the car. Communication with activity lights the brain up more with better engagement.
Another definition of yoga is "hip restoration". Not only is this practice beneficial for full body flexibility, total balance, and connecting the mind, body, and soul but it will create bullet proof hips. I really enjoy a warrior pose combo from Warrior 2 to 1 and finish with some balance on Warrior 3 to really engage the hips with balance, stability, and control through range. The ancient yogis were obviously long-distance runners. A study in the International Journal of Physical Medicine and rehab (ISSN: 2329-9096) showed the yoga group to have a greater effect on range of motion at the shoulder and hip than static stretching in a healthy population. Not starting some form of yoga practice will curtail your running performance and enjoyment - so please look for a class that suits your schedule and your hips will thank you.
Hip Care Tips
1)Get a standing desk, sit less.
2)Swim with a range of strokes (triathletes PLEASE get proficient in more than just freestyle, and runners start swimming)
3)Ride your bike to work, scooter to school, walk more.
4)Start a yoga practice and do a little daily (you brush your teeth twice a day)
5)Run with QUALITY rather than ticking off miles with poor form or niggles - niggles is your body communicating with you.
Brad Dixon is a sports physio, coach, and wellness evangelist based at EVERFIT Physio & Coaching. His passion is promoting enhancing daily habits that nudge people towards potential and save the planet. The power is in our daily habits! Connect with Brad at www.everfit.co.nz, Facebook, Strava, and Instagram (@everfitcoach).