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Have you noticed we have focused on hip strength a lot lately? We had a post connecting lower back and hip strength, and another on how hip mobility can determine if you have injuries in your future. Hopefully by now you see just how important hips are within the entire chain of your body and its movements.
Good hip strength has been linked to a lower risk of IT band syndrome, patellofemoral pain syndrome (PFPS, also known as “runner’s knee”), shin splints, and low back pain, in addition to a lower risk of injury overall.1, 2
However, as runners we can sometimes be stubborn, and ignore the warning signs telling us that this is a pain we should not be running through. Before you know it, you are struggling with one of the above-mentioned injuries. You start going to a good physical therapist who keeps up to date on the latest research on running injuries, and you are prescribed a hip strengthening program for rehab.
How long will it take to build hip strength?
Obviously, every injury is different, but looking to research that uses hip strengthening programs to rehab an injury associated with hip muscle weakness can give us some idea of the timeframe to total recovery.
We will focus on studies that successfully treat running injuries with hip strength rehab programs.
The first study we will look at was published in 2006 by researchers at the University of Kentucky. In this study, a quadriceps and hip abductor strength routine was used to treat PFPS in fourteen subjects.
Over the six-week duration of the study, knee pain gradually diminished, with the decrease becoming statistically significant after four weeks of strength training.
In 2006, a study of PFPS successfully treated thirty-five patients using a six-week hip flexion strength program,4.
Another study in 2000, looked at runners with IT band syndrome following a six-week strength program with success5. However, neither of these studies took week-by-week measurements of knee pain.
A 2011 study matched the four-week marker by demonstrating that a hip strength program resulted in superior results compared to a quadriceps-strengthening program for treating PFPS in runners after four weeks of rehab work.6
A 2011 study by researchers at the University of Calgary showed that a simple hip strength program, completed daily, produced very good results in a small group of runners with PFPS.7 Other than this small study, I have not seen any research using a shorter time period.
Individual differences with rehab
These studies varied in the details of their design, but one element they all shared is that the rehab exercises were done quite frequently—at least three days a week, and in some cases, every day!
Even with regular rehab work, it is likely to take three to four weeks for to see some real results. Remember, these are studies of many individual runners who may have the same injury, but may have varying levels of the injury. For example, someone with only minor hip weakness contributing to IT band syndrome might see results more quickly than a more painful case of IT band syndrome with more significant hip muscle weakness, who may take longer to recover from, even with the right rehab program.
Even the perfect rehab exercise routine will take a while before is has a significant effect, so if you are injured, be patient! You will not return to full strength overnight. Research indicates that successful programs, on average, take three to six weeks to have a significant impact. Give your rehab program at least this long to kick into effect before you ditch it for something else.
During this time, if you cannot run without pain, you can try to maintain your fitness through cross training, assuming it does not irritate your injury. Unfortunately, there is no quick solution to running injuries.
In the past, we wrote an article on how children can be compared to a spring in the way they run.
By looking at the way children run, and then monitoring the changes as they grow, we hoped to find some useful insights into our own biomechanics.
Today, we are going to follow runners at the opposite end of the spectrum by looking at how running mechanics changes as you age.
If you are an older runner, in your fifties, sixties, or even seventies, do your mechanics fundamentally change compared to a younger runner?
It is no secret that runners do eventually slow down as they age. After the age of forty, runners slow by an average of 1-6 seconds per mile,1, 2, depending on the race distance.
Research published in 2008 by Italian and Brazilian researchers Giovanni Cavagna, Mario Legramandi, and Leonardo Peyré-Tartaruga attempted to illuminate the biomechanical changes that occur in older runners.3
Cavagna et al. recruited eight healthy men in their late sixties to seventies, three of whom were trained runners. The researchers had the men run at different speeds along a fifty-meter runway, recording data about their impact forces, and the motion of their joints. The running mechanics of the older men were compared to the same tests on running-mechanics of college-aged men. Again, three of these subjects were also trained runners.
By examining the differences in running mechanics at a broad range of running speeds (as slow as a thirty-minute mile shuffle and as fast as 5:40 mile pace in the older subjects!), Cavagna, Legramandi, and Peyré-Tartaruga were able to demonstrate certain similarities and differences between the older and younger runners.
The older runners were not able to generate nearly as much vertical “push” off the ground as the younger runners because of their decreased ability to generate muscular power. In fact, younger runners were able to attain a 75% higher peak vertical acceleration when running at high speeds compared to the older runners.
This lack of muscular power has significant implications on the biomechanics. Younger runners generate vertical power to adopt a longer “loping” stride that spends more time in the air than on the ground.
Older runners cannot generate the same muscular power, and are therefore forced to adopt a much higher stride frequency to run at faster speeds.
In this sense, the concept of the “old man shuffle” has some truth to it.
The inability of older runners to generate enough vertical power to enable an “asymmetric stride”—one which spends more time in the air than on the ground—implies that their efficiency is diminished significantly at speeds faster than 8:45 per mile. This is the point where the most optimal stride patterns change to a floating, asymmetric pattern.
An additional barrier to efficient running comes as a result of the higher stride frequency: with less time spent in the air, there is also less time for an older runner to swing his or her legs forward, meaning the “shuffle” must be very quick and inefficient. At higher speeds, this importance is magnified.
Compared to younger runners, older runners become even more inefficient as speeds increase.
If your goal is to avoid or limit these age-related changes in running efficiency, it is pretty clear that you should aim to build or at least maintain your muscular strength.
Cavagna, Legramandi, and Peyré-Tartaruga identify two main reasons why older runners (and older people in general) cannot generate as much muscular power: loss of muscle mass and loss of force production at the cellular level in the muscles. Weight training should address both of these issues.
If you are over the age of fifty, and you are not lifting weights once or twice a week, you should be! Your focus should be on increasing the strength of the major muscles in your legs: the quads, glutes, hamstrings, and calves. These muscles are what generate power during your running stride. Keeping them strong will hopefully stave off the age-related changes in running mechanics.
There might be a silver lining to these changes; a higher stride frequency implies less force going through the body with each step, which might explain why older runners have a lower incidence of many common running injuries.4
So, getting older does not mean all bad news!
This week we have shared a post from Matt Fitzgerald with 10 Tips to Tame the Hills of Boston, and the Ultimate Guide to Downhill Running. We also relaunched our podcast with Boston Marathon race director, Dave McGillivray. We will be adding these to our current Boston Marathon posts to give you everything you need to have your best race possible in April.
Here is the full list of all of our Boston Marathon related posts:
We would love to hear how your training is going, and be a place for you to see how others are getting along in their training.
Running the 2015 Boston Marathon? Get our Boston-specific training articles, exclusive access to our VIP Boston events, and the latest on where, when and how to meet the RunnersConnect team. Click here to stay updated
If you are feeling a little overwhelmed, and would like to see how some of the experienced marathoners are approaching their training, check out our c0-hosts for this post:
If all this Boston Marathon talk has you excited, but you have not yet dipped under that magic barrier, you can check this out to Reach Your Boston Marathon Dream.
Ask a group of runners from anywhere in the world what races are on their running bucket list, chances are you will hear the same marathons over and over: London, New York, Paris, Frankfurt, Vancouver…