Dynamic Biomechanical Screen
Name: Nathaniel Huff
Biomechanical Interventions
Hi Nathaniel– Thanks for coming in today – great to meet you! We are looking for reasons why you’ve had persistent issue
with your right hip. We were able to objectify your issues, and make some corrections. These issues stem from an increase
in volume and intensity on a body that didn’t have enough strength to control the hip. Thus you’ve allowed some
postural alterations to creep in, and set off a chain reaction. I’m very glad things are getting better, but I’d like to
eliminate the issues that got you into this mess in the first place. Your issues stem from imbalances that are TOTALLY
correctable.
1.
Hip rotational stability –you run forward - this is called the sagital plane. Running is a great way to strengthen
sagital plane muscles such as the quads, hams, and calves. However, running alone does NOT develop the
muscles that control the rotational alignment of your hips. Your glut medius and glut max together stabilize the
internal and external rotation of the pelvis on the hip when running. Your weakness on the right side allows your
hip to rotate an extra 10 deg as compared to the left. It should be noted that this is over 22 degrees.
Strengthening the rotational control of your hips in closed chain exercises such as the ones we reviewed today
will address this deficit. This will help you stabilize rotation of the hip, as well as eliminate the trunk shift you have
when you run.
2.
Hip extension weakness – this is the driving factor behind your issue. When you stand, you have a slight increase
in the arch (called lordosis) of the low back. This is not really a huge deal if you had good hip extension
strength. However, your glut max is very very weak. So weak that it allows you to adopt some very significant
postural changes when running. You keep your back in extension (arched) but you pitch forward from the
pelvis. Thus you body looks like it is leaning too far forward. Why is this bad? Well – it overworks your hip flexors.
Basically, you’ve been giving yourself a hip flexor impingement from excess strain on this muscle group. You
have GREAT hip extension, but you can’t use it when you run due to your faulty mechanics. We approached
your issues in 3 parts today.
a.
Learning what muscles do what – the clamshells and fire hydrants are great exercises to LEARN what
muscles you are trying to focus on.
b.
Strengthening -The sling exercises with the rope and the twisting lunge and singl leg dedlift are
exercises that cue you to USE this new muscle control with functional exercises. Instead of just pushing
against a bolster, it forces you to stabilize motion as you move.
c.
Integrate into running form – I DO want you paying attention to your form, but right now, the glut
muscles are just plain weak……it will take several weeks for them to improve strength. You need this
strength to do a better job of keeping your pelvis level and extending your HIP – not your BACK.To
help you do this when running, think about lengthening skin on the back of the neck, and doing the C
skips to help you improve your use of your hip extension mobility. Remember, you have great hip
extension – its your postural abnormalities (driven by weakness of the hip extensors) that prevent you
from using it. While you are gradually building up your mileage, do it with good form. The more you
focus on it now when mileage is low, the easier it will “stick” when miles get high.
We need to get this chassis back in control so you can begin to generate some serious horsepower!
Exercise Recommendations
Stability Phase 1
1. Single leg balance –properly align posture, drive big toe down, and then rotate/close eyes/throw a ball to
increase challenge
2. Clamshells -100 reps each side daily for 1.5 weeks
3. Fire hydrants – 100 reps daily with dowel across the back to keep spine in neutral
4. Tball triad – 2 sets of 10 of each of the 3 parts- can eventually work up to single leg
Stability Phase 2
1. Supine Hip rotation with leg in sling -30 reps total (3x10)
2. Sidelying hip ADDUCTION with leg in sling – 30 reps total
3. Sidelying hip ADBUCTION with leg in sling -30 reps total.
4. Single leg dead lift – dowel along the back, keeping hips level as you bend forward. Then push the pelvis
forward to come up from the glutes.
5. Rotational Lunge -3-4ft stick across shoulders. One foot well behind body up on a stool. Drop down as if sitting
on a chair behind you, twist 45 deg right, center, and 45 left center and back up. Do 3 sets of 10 each leg.
Running Form
1. Posture – try to correct this all the time. Slightly drop your chest forward to put even weight over your forefoot
and rearfoot. Practicing this ALL the time (numerous times through the day for 30 sec) will make it easier to find
when you are running. Imagine lengthening the skin on the back of the neck –this will help you avoid excessive
lumbar extension or curve
2. C Skips- after you get the single leg dead lifts down a bit, use this motion pattern to help you with the C skips to
drive off the hip extensors.
Nathaniel –I know you learned a lot of info today; the key is making some time to work on it! Learning to use specific
muscles to control hip rotation and extension will improve dynamic alignment. Then changing muscle memory via
the gait cues will make it all part of your running style – hope you and your friends had a great spring break – all the
best to you in your running and beyond!
- Jay Dicharry, MPT, SCS, CSCS