Pelvic Biomechanics
 

FIGURE 1

 Better performance is achieved by consistent training, and workout time lost due to injury will make reaching your goals much harder. This months performance tip centers on injury prevention. Given that overuse injuries are very common in runners, the early recognition of factors that predispose to injury is very important. The first concept to appreciate is that overuse injuries are the result of small amounts of damage summed up over a long period of time. A slight deviation in motion or strength can, over time, lead to a big problem. You may be happily running along for weeks or months without noticing anything, but the injury is slowly developing. When it does finally hit often the underlying problem goes undetected. After all, why would you suspect your foot to be the cause of your back pain?

Although there are many possible areas of abnormal biomechanics, a common one, sometimes overlooked, is the pelvis. Abnormal pelvic motion during running can put undue strain on a variety of structures and lead to overuse problems. However, before you begin cursing your pelvis, understand that sometimes abnormal pelvic motion is merely a result of a problem elsewhere. Looking at, and correcting, abnormal pelvic motion can help you discover these hidden problems.

To appreciate the abnormalities that may occur in running, picture a box around the pelvis (fig.1). The two most common situations are,

  1. the pelvis is tilted forward (anterior tilt); slightly rotate the box forward
  2. one side of the pelvis is lower than the other (lateral tilt); slightly tip the box to one side.

Each of these abnormalities has its own specific range of problems (see table 1), and sometimes both can occur.

 

So how do you find out if you're experiencing abnormal pelvic biomechanics? There are several clues to explore. Look at the wear on your shoes, if it is asymmetric, then you know that one leg is doing something different. This may not involve the pelvis but it is a consideration. Try this simple test. Perform a one leg squat, first with one leg and then the other. Go down to about a 90-degree bend in the knee. Watch yourself in the mirror. If balance is harder, or you find that one side seems weaker, tight, painful, or less coordinated, then you need to look more closely at pelvic biomechanics. If you have experienced any of the overuse injuries listed in the table, then you should definitely consider pelvic biomechanics.

To look specifically at what is happening requires outside assistance. An experienced running coach or runner can look at your form and give you feedback. Because some abnormalities are very subtle, video taping is often quite helpful. Once the abnormality is identified, then hunt for the associated tight or weak muscles, and/or related problems (e.g. overpronation, leg length discrepancy, etc...) and fix it.

 Direction
 Associated injuries
 Potential cures
 Anterior tilt
 1.) Low back pain

2.) hamstring strain

3.) patellar tendinitis

4.) patellofemoral syndrome

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And if the angle of gait is widened,

lower leg problems such as shin pain

 A) Abdominal muscle strengthening

B) Stretching and strengthening of gluteal muscles, hip external rotators, hip flexors, and hamstrings

C) Balance and retraining (e.g. one-leg squats)

 Lateral tilt
 1.) iliotibial band friction syndrome

2.) low back pain -- usually one sided

3.) adductor (groin) strains

4) lateral hip pain

 A) Look for leg length difference, overpronation in one foot, etc. and consider orthotics to correct.

B) Stretching and strengthening of hip adductors, abductors, extensors, and ext. rotator muscles.

C) Balance and retraining (e.g. one-leg squats)

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