The weakest link: Strengthen the chain and prevent injury

Injuries occur at the weakest points in your body. Gerald Smith investigates how a weak link at the hip can lead to injuries at the knees

You are only as strong as your weakest link, and although core strength reduces your chances of picking up an injury, it may not be the area you need to focus on. You need to take an individual approach to injury prevention? You can do this by analysing your body with movement screen, or get a professional to perform one on you to find out where you are weak. Weak links can be caused by poor technique, previous injury or muscle weakness and over time can manifest itself into an injury. This article explores the hip joint and in particular the hip abductor to see what injuries can be caused by weakness there and how we can identify muscle imbalances of the hip.

Weakness at the hip joint can lead to injuries at the ankle or knee where almost 50% of injuries occur. The key injuries caused by a hip abductor weakness are illiotibial band friction syndrome, which is where you get a pain on the outside of the knee. Hip weakness is also a factor in patellofemoral syndrome (PFS). These types of injuries are classified as an over-use or over-training injury but I think it is more accurate to use the term running imbalance injury. This term helps to explain the unbalanced training regime which occurs from running without an injury prevention strategy like strength training.

There are many factors that can predispose you to acquiring a weak link at the hip joint, and for simplicity I have put them into 3 categories that are:

1. Structural predisposition to injuries. This is based on factors such as any structural changes that are caused by previous sessions, previous injuries, posture at work (if you sit at a desk), leg length discrepancies (one leg being longer than the other), high arches and ageing.
2. Technique stress. This is dependent on your running form (leg crossing the midline of your body), running posture, running shoes v barefoot running
3. Physical stress. This includes the environment (temperature), intensity, sleep, frequency of training, duration of training.

Many problems with running technique and poor posture are caused by muscle imbalances. This can lead to weakness at the hip joint. We all have muscle imbalances caused by over used muscles shortening and becoming stronger and underworked muscles lengthening and becoming weaker during running. The weak muscle, which in this case is the hip abductor, is normally a muscle responsible for stabilising the joint.

Let me explain why stabilisation is important. Think of your hip joint as a table with four legs. To provide the greatest stability you place the four legs around the edge of the table. Now if you place the four legs in the centre of the table, or near the centre of the table then its stabilisation decreases. If you put any type of force on the table the table collapses. This is why joint stabilisation is important because at some point an unstable joint will give way and cause injury.

The hip abductor plays an important role during running. When you are on one leg (right) during the swing phase of running (one leg on the ground) the hip abductor muscles prevent you from falling over to your opposite side (left) as they stabilise your pelvis. The old saying that hip bone is connected to the thigh bone is very true, because the body works in a sequence of reactions. For example, if you use your hip muscles to move your leg as far forward in front of you as you can, then your shoulders go back. If you push your leg as far back behind you as you can, your shoulders go forward, and if you push your foot out as far to the left as you can then your shoulders go to the right and vice versa. The point I am making is it that what happens at one body part (like the hip) can impact on another body part (like the ankle), or even up to the shoulder because the body is interconnected and works in sequence.

Now the importance of your hips to what happens during running is that it can control what happens at the knee joint which can have a major impact on your running technique. For example, if the hip rotates inwards than the knee rotates inwardly placing the knee in an unfavourable position, and placing great strain on your ITB, which will lead to an injury. This unwanted deviation can be caused by muscles which are too strong pulling your leg in this direction. In order to prevent this it’s important to stretch key muscles like the adductors which are on the inside of the leg, stretch the IT bands, and strengthen your hip abductor muscles. Runners that have been given exercises to strengthen the hip abductor muscle have seen a decrease in pain after 6 weeks, so an injury prevention strategy would be to make sure this muscle doesn’t get weak.

There is one key exercises I recommend you use to strengthen your hip abductor. One is a one legged squat and the other is a reverse lunge. However it is important to assess your needs first before just adding these exercises. One way to test your running imbalances is to use the over-head squat (see below). This is a test that you can do at home and all you need is a long stick.

To perform this test stand in front of a mirror with your stick held above your head, keep your head back, and bend your knees so that your bottom lowers towards the floor. As your lowering down please make sure your the stick does not come forward, because this may suggest you are tight in your upper body. Your ankles must remain on the floor, the stick must remain in line with your ankles, and the back should be straight

There are many problems that could occur when you perform the movement screen. It doesn’t mean that you will get an injury but you are more susceptible to an injury than someone who performs the screen perfectly. For anyone who has the 1st symptom, the exercise below will help.

One legged squat: Make sure your hip remains level, pull your tummy in and make sure your knees stay in line with your 2nd toe. Lower yourself 6 inches with out your knee deviating from straight vertical path

Reverse lunge: As your knees are bending keep your knees in line with your 2nd toe. If your knee deviates from this straight line squeeze the Glutes and get the knee back in line

Gerald Smith has a bachelor’s degree in exercise, nutrition & health from Roehampton University and is a member of the register of exercise professionals. He has worked in the fitness industry for over 10 years and has many years of experience in personal training.

Gerald’s background is as an endurance athlete where he has competed in rowing, and he currently works as strength and conditioning coach for London rowing club. Gerald has developed a passion for sport, and he uses this passion to help athletes from different sporting backgrounds to reach their fitness goals.

Gerald’s own experience of athletic competition and training, combined with an in depth knowledge of sports and performance from his continued education makes him able to train all athletes individually and uniquely.

Email: sc.geraldsmith@yahoo.co.uk | Website: www.slimmerfitterstronger.com