Pre-hab Workouts for Injury-Free Running

April 20, 2009
By Curb Ivanic

To run efficiently and stay injury-free, runners need the balanced and unified function of many muscles. The glutes, hamstrings, quads and hip flexors, collectively called the prime movers, propel the body forward. Stabilizer muscles in the hips and torso work to support the pelvis and spine. The calves and lower leg muscles assist with forward motion and balance. The shoulders and back swing the arms to move in sync with the legs.

Overuse Injuries:

Due to the activity’s repetitive nature, running carries the risk of overuse injuries. Repetitive movement in one plane of motion can lead to muscle imbalances that increase the risk of injury. The yearly incident rate for injuries is in the range of 37-56 per cent, and of these, 50- 75 per cent are overuse injuries, as reported in a literature review in the journal, Sports Medicine. Rehabilitation of these injuries can take quite a long time.

An ounce of prevention:

The ideal strategy is to prevent muscle imbalances in the first place or correct them when the differences are minor. A regular program consisting of strength exercises, dynamic flexibility exercises, myofascial work with the foam roller and static stretching will keep your body in balance. Your strength workouts are a major component of pre-habilitation, or “pre-hab” - preventative exercises that help your body withstand and counteract the repetitive stresses of running.

An example of muscle imbalance: the lateral subsystem:

Researchers have grouped muscles into systems to simplify and explain movement. Of special concern to runners is the lateral subsystem, comprising of the muscles listed below.

Muscles of the Lateral Subsystem:
Muscle	Location
Quadratus Lumborum (QL)	From the lower spine to top of the pelvis.
Gluteus Medius	On the rear of the hip.
Tensor Fascia Latae (TFL)	On the front of the hip.
Adductors	Along the inner thigh between knee and pelvis.

The quadratus lumborum on one side of the body works with the opposing adductors, tensor fascia latae and glute medius to stabilize the pelvis and help control the femur as you run (see Fig. 1). When this system becomes unbalanced, it will almost certainly lead to injury. Imbalance in the lateral subsystem causes instability in the hips and changes the loading pattern on your body as you run. One of the most common injuries is illiotibial band syndrome (ITBS). With this injury, the band of fascia that runs down the outside of the thigh from the hip to the knee known as the illiotibial band becomes tight, causing pain on the outside of the knee.

A major contributor to the tight illiotibial band is glute medius dysfunction,  while weakness in one of the prime movers or another stabilizer muscle is a major contributor to the dysfunctional glute medius. With a pre-hab conditioning program, this imbalance is preventable.

Basic strength program guidelines

To properly balance your body, you need to work your primary running muscles, as well as your supportive musculature. Choose eight to 12 exercises to work the entire body during each workout, and complete 2-3 sets of each exercise as a circuit or in groups of two, three or four exercises done back to back.

As a general rule, to develop muscle activation, complete 12-15 repetitions per set; to work more on pure strength complete 6-8 repetitions per set. The pure strength work is more appropriate for larger muscle groups such as the legs, glutes and shoulders with exercises such as lunges, squat jumps, and shoulder presses. Muscle activation work is better suited for stabilizer muscles and stabilization type exercises.

Don’t worry about resistance training cutting into your running time. A well-designed program can be completed in as little as 30 minutes, two to three times per week. It can be done in a gym or at home but does not require a lot of fancy equipment; your bodyweight, some dumbbells and/or exercise tubing are all you need.

Pre-hab program exercises

Running is predominantly a forward movement, so you should include lateral and rotational exercises to work the body in all three planes of motion. Side lunges are a great example of a lateral exercise (Fig. 2). Oblique twists illustrate a rotational movement (Fig. 3).

You should incorporate full body exercises, co-ordinating movement between the left and right sides and between the upper and lower body. This trains muscle activation patterns and improves integration between muscle groups. An example would be a forward lunge with an arm drive (Fig. 4).

Stabilization and balance training is also important. A one-leg squat with a toe touch is a good stabilization and balance exercise (Fig. 5 & 6).  This is an excellent exercise to do before a run to fire up hip and ankle stabilizer muscles.

Include plyometrics to develop power. These are jumping exercises that involve fast, explosive movement such as squat jumps (Fig. 7 & 8 ).

Core stability exercises will target the muscles of the hips, abs and low back. The prone plank is one exercise that targets the core (Fig. 9). Hold this position for 30 seconds and increase the duration as you get stronger.

Following these strength-training guidelines, along with proper stretching, will help runners stay injury-free by preventing the muscle imbalances, using pre-hab to avoid the more painful route of rehab.

Curb Ivanic is a Vancouver-based performance enhancement specialist with a masters degree in Exercise Science. He enjoys running distances from 10K to 50K (www.ultrafitness.net).