At some point during graduate school, I fell out of love with running. I’m not completely sure why. Maybe it was Lance Armstrong. At that time Lance was dominating the Tour de France which influenced my growing interest in cycling. May be it was that I had run my whole life and I just needed a break.
As a physical therapist and a human I have always been fascinated with how are we supposed to be. What I mean is, all of us function every day in some way, but what is the difference between normal functioning and efficient, thriving function? At some point I read “Born to Run”. What a great book. I became very interested in shoes and again my love of running was activated. So began my thirst for knowledge and desire to become an efficient core runner.
Running is a whole body activity. In the efficient state it occurs with reciprocal trunk movements and is driven by the core. The core (figure 1) should be thought of as a barrel with a top (respiratory diaphragm), bottom (pelvic floor), sides (obliques and transverse abdominus), back (quadratus lumborum, multifidi) and in the middle the psoas muscles. These muscles function as a unit, not in isolation.
The question is how do we activate the core? Let me set the stage with some research. Studies show people with low back pain have altered running movement patterns and that after an injury, recovery of the multifidi (a low back and core stabilizing muscle) is not automatically restored. In addition we don’t have to have a specific injury to create core muscles that don’t work for us. Prolonged bad postures such as slouched sitting or repetitive movements to the point of fatigue (such as distance running) may also turn the core off. The deactivated muscles have to be taught to work again. This is best done through an activity we in physical therapy call, bracing. Bracing does not isolate only certain muscles to fire, but rather encourages all stabilizing muscles (the barrel noted above) to activate. An example of a bracing exercise is pictured in figure 2 below:
Be warned, however, that doing such an exercise will be of little benefit if you carry yourself in a slouched posture (see figure below). Such postures actually turn off your important core muscles. In addition, if you have a mechanical problem in your hips, pelvis, or spine your core muscles will be turned off and exercise will not be effective in activating them.
Our Body Mechanics physical therapists address these challenges in the following manner:
- We examine you by watching you move and feeling where your specific mechanical issues exist. Often we find tightness in certain joints of your spine, in surrounding connective tissue or fascia, or in tender and tight muscles that limit your range of motion and cause your core muscles to be inhibited. Specific, skilled manual therapy methods are applied to restore your optimum mobility and function. You won’t need manual physical therapy forever, but getting things moving properly will make your exercises work effectively to maintain your improvements.
- We teach a variety of bracing exercises in progressive degrees of difficulty with a variety of positions and methods. We instruct bracing to be done regularly and repeatedly to keep the core on! This may vary from multiple times per day to once every other day.
- Efficient, balanced posture needs to become your subconscious habit. We can train you in this posture with repetition and a growing internal awareness of your position in space. Not only will your running posture and form need to be trained, but your habitual sitting, standing, and even sleeping posture are usually addressed to have a positive influence. Each individual has their own posture and therefore his or her own unique correction. The postures in the figure above serve as examples of two non-neutral postures and the correct end result. If you are unsure, specific clinical tests that we perform can help you figure it out, and feel it in your own body so that you can make the necessary changes.
- As athletes we go through cycles of injury or pain and cycles of feeling well. We recommend that you visit our physical therapists every 3-6 months for a checkup even when not in pain. If you are pressing your limits in training, perhaps you will benefit from more frequent follow-up visits. As we get to know you and your body, we are able to quickly determine problem areas and provide treatment with hands on manual therapy and muscle retraining.
Call for an appointment today in Madison (608) 422-5085, Milwaukee (414) 224-8219, or Pewaukee (262) 695-3057. You can also direct inquiries by email to firstname.lastname@example.org and become a fan of our Facebook page.
By Adam Lindsey, PT Director at Body Mechanics, Madison, WI