I have been asked by the Running Room to become a regular contributor to the Magazine and this article marks my first contribution. A quick introduction is in order. I am an Associate Professor in Kinesiology and the Director of the Running Injury Clinic at the University of Calgary. I hold a Ph.D. in gait biomechanics and sports medicine and am also a certified athletic therapist. My research specialization is prevention and treatment of running-related injuries and I’m also a Population Health Investigator through the Alberta Heritage Foundation for Medical Research. My research training was at the University of Oregon — Track Town USA — and I had the pleasure of shaking hands with the great track coach Bill Bowerman back in 1997. Finally, I’m a “plodder” as I run a 2-hour half marathon and a 4-hour marathon.

In this issue, I want to discuss core stability training since it is gaining popularity in the running community, as more runners are made aware of how weakness in the “core” of the body can negatively influence lower extremity biomechanics and lead to injuries. The lumbar, pelvis and hip region together are considered to be the core of the body. Unfortunately, the hip musculature is often neglected even though much research has been conducted to understand its importance. From a biomechanical perspective, proper core strength is essential to adequately control and allow proper biomechanics while running. Here’s the science behind this concept.

Running is essentially a repetitive process of losing then regaining your balance. When you run, your center of mass (COM) does three things. With each step the COM accelerates upwards, forwards, and outwards. Interestingly, most all of your leg muscles function to control the upward and forward acceleration in terms of absorbing contact forces and generating propulsive forces. It is the outward acceleration of your COM that can cause so many injuries. The reason is that the only muscles that work to minimize the outward acceleration of your COM are the hip abductor muscles — the muscles on the side of your hips. Thankfully, your arm swing also functions to counteract the outward acceleration as well but adequate hip abductor strength is a key ingredient to staying injury-free and also to optimizing your rehabilitation if you are injured. Interestingly, the research behind adequate hip strength has only recently come to the forefront.

The first studies were only conducted in 2005 but almost each year since, a research study has confirmed that weakness of the hip abductor muscles is a key factor related to the development of various running injuries. We conducted a large study in 2006 involving over 300 patients. Patellofemoral pain syndrome (PFPS), IT band syndrome, and shin splints accounted for the majority of injuries. Based on a biomechanical and clinical evaluation, a rehabilitation program was prescribed to improve hip strength where necessary. Upon follow-up, 92% of the patients reported an average 75% improvement in pain regardless of whether they had a knee, ankle, or hip injury. We have since repeated this type of research for runners with low back pain, IT band syndrome, and PFPS and even for patients with knee osteoarthritis. Our most recent research just published in April in the Journal of Athletic Training is the first study to show that improving hip abductor strength results in a more predictable and consistent movement pattern as well as reducing the pain associated with PFPS. The collective results from our research lab and other labs around the world suggest that a hip strengthening rehabilitation program, based on the biomechanics of running, can effectively prevent and resolve running-related injuries.

The exercises to improve hip abdcutor strength are quite simple and easy to implement into your training routine. Perform these two simple exercises every day and progress up to 3 sets of 10 repetitions over a 3–4 day period to avoid muscle soreness. Gently stretch before and after and remember to ALWAYS perform these exercises AFTER a run! Remember, these are your key stabilizing muscles and if these exercises are done before your run, you’ll be running with fatigued stabilizing muscles and the risk of injury increases.

As a final note, several factors are related to a running injury. However, based on our research, you should perform these 2 exercises every day for the next 3–4 weeks to gain the necessary muscle strength to avoid injury and optimize your rehabilitation. Then, simply performing them 2 times per week thereafter will serve to maintain the strength you have gained.

© 2017 Running Injury Clinic