How to Identify and Fix the Most Common Reason for Running Injuries

Guest [00:00:06]: Hi. This is Dr. Lauren Lafier, and this is the Run to the Top podcast.

Finn Melanson [00:00:11]: Hello fellow runners. I'm your host Finn Milanson and this is the Run to the Top podcast, the podcast dedicated to making you a better runner with each and every episode. We are created and produced by the expert team of coaches@runnersconnect.net where you can find the best running information on the internet, as well as training plans to fit every runner in every budget. Are you a runner that has suffered from hip related injuries, weakness or mobility issues?

Finn Melanson [00:00:47]: Do you suspect that these issues are.

Finn Melanson [00:00:49]: Having a negative impact on your training and racing? Well, you're in luck because in this episode, runner rehab specialist Dr. Lauren La Pierre returns to the show to discuss all things hip strengthening. Specifically, we discuss the warning signs or symptoms of hip dysfunction, common causes of hip tightness and restricted mobility in runners. How hip mobility impacts running efficiency and performance specific hip stretches, mobility exercises and strength training for runners to consider the role of hip flexibility in range of motion and its impact on running mechanics, as well as cross training exercises that specifically benefit hip health. If you've tried running with headphones before but didn't like how they felt, then you really need to give oledance headphones a try. You'll be amazed at the difference their open ear design makes. Head to oledance.com forward slash RTT to learn more. Timeline Nutrition has developed a groundbreaking product called Mitopure that revitalizes your mitochondria which create energy in nearly every cell in your body. Head to Timelinenutrition.com to learn more.

Finn Melanson [00:02:05]: Lauren La Pierre. Welcome back to the Run to the Top podcast.

Guest [00:02:09]: Thank you. I'm so excited to be here.

Finn Melanson [00:02:11]: It's great to have you here. I know that the last time we had you on it was a very popular episode, a lot of curiosity from the audience and in that episode we discussed lower back pain issues as they relate to our running lives. And this time around I think we're going to be focusing on hip issues, hip strength, hip mobility, et cetera. But before we get into that, for any listeners that might not have caught that last year's episode that are curious, can you talk briefly about your background in physical therapy and in running?

Guest [00:02:41]: Yeah, absolutely. So I am a doctor of physical therapy and a runner, rehab specialist and running coach. And so I have been working in, I mean I have been a runner for almost two decades of my life now. I started running when I was twelve years old and I guess you can say how I ended up going into physical therapy was because of my running career. Because when I started competing more at the collegiate level, I had professionals telling me that I wasn't built for running and all of my injuries were essentially my body's own fault. And I was like, this can't be true. And so I became more curious and started to look further into the science behind it and what actually needs to happen in terms of training loads and the physiological changes as well as then the strength side of things that are necessary for all runners. And that was what helped me heal my own body. And I have just kind of taken that a step further since getting my doctorate degree in specializing in running and figuring out what I kind of use my own kind of hybrid training model now to kind of create the programs that I have to help runners. So I've owned my business for the last three years, worked in orthopedic clinics prior to that, prior to taking my business full time. And my business is primarily virtual. So I work with runners all over the country as well as even worldwide to help them with their performance and running pain free. And yeah, that's kind of like the last almost 20 years of my life.

Finn Melanson [00:04:29]: Awesome. Well, yeah, like I said, you were on the show about ten months ago, provided an awesome master class in addressing low back pain and runners. We'll link to that in the show notes and we're kind of on a nice little tradition here. Maybe we'll have you on again after this episode to just bit by bit, unpack human anatomy going down the train right down the chain. Exactly. And I think where I want to start this conversation as it relates to the hips in running, what are some of the common causes of hip tightness and limited mobility in this area of runners? And yeah, first if you could talk about just the source of all of those issues and then maybe we can from there talk about how it can be addressed and whatnot.

Guest [00:05:14]: So I have probably a different perspective than most physical therapists out there and I think I'm going to say this is what makes me a little bit unique in the way that I kind of quote, unquote treat things when we look at the hip. The hip is a really dynamic joint in terms of the fact that it has a lot of different planes of movement and so that gives it a lot of variability. With a lot of different ranges of motion, though, come the option for different muscles to kind of work. And muscles don't turn on and off, they are constantly working. But just we have a lot of variability and options and so that requires a lot of stability and strength. But inherently because of the way that the hip is designed, it's not always easy to necessarily leverage and access these muscles that we should, quote, unquote, be using during our running. And so that ends up resulting in us kind of biasing and overutilizing certain muscles like our quadriceps. Like, I bet there are 100 runners out there that have heard that they're quad dominant runners or using our lower back muscles. Our quad muscles are very strong muscles and our lower back muscles are actually very strong muscles. And because of that, we're more often going to leverage them because it's easier to our brain is like, oh, I have these really strong group of muscles here, I'm just going to use them versus use the hamstrings, which are a smaller muscle group, but efficient and effective and necessary in running because it's easier. So the body is always going to find the easiest direct access route. The body's like and the brain's primary design is to do the easiest thing with the least amount of energy and oftentimes that results in us using those larger muscle groups. And because we're just constantly using those larger muscle groups, that's where we're going to essentially have a bias that's going to result in maybe some tightness or weakness in the hips in other areas.

Finn Melanson [00:07:34]: Interesting. So with a lot of the runners you work with, you find that they're quad dominant, they have strength in their lower back. When you say that there are other muscles we should be using, are you referring to like the glute muscles for example?

Guest [00:07:46]: Glutes, yes, I think it's again the way that we should be using our glutes, that's not often taught but glutes adductors. So your inner thighs not abductors. Everybody thinks about abductors and that's where like clamshells and things like that. Yes, those are important too, but I think again they're probably over promoted in fitness culture and things like that now. So I'm talking about your inner thigh muscles, your add ductors and your hamstrings. I think add ductors and hamstrings are probably the two muscle groups that are probably under focused and not as thought of as much in running. But they're actually two of one of the most important muscle groups that I focus on with my athletes to get them stronger.

Finn Melanson [00:08:36]: Okay. And so to come back to the question around hip tightness and limited mobility, is it because we're using muscles above and below the hips and there aren't those muscles in that area being used that causes those issues or what's the.

Finn Melanson [00:08:49]: Source of all that?

Guest [00:08:50]: Yeah. So again this is going to be a super simplistic kind of visual for people because you can see me talking to you but not everybody else can. So if we're constantly using our quads and our quads are more concentrically working so shortening so they're being pulled together, that's going to bring our hip and our knee closer together, that's going to tilt our pelvis forward. And then if our back is also constantly working or is working harder, then again that's going to tilt the back of the pelvis up. That's going to shorten the distance between the bottom of the back of the rib cage and the top of the pelvis. That is what's probably going to create that sensation of tight hip flexors in the front of the hip joint as well as maybe even some tightness into the back of the hamstrings, because the hamstrings are essentially lengthened to the max, so they're actually already on stretch. And then our hip flexors are probably really shortened in the front because of that tilting of our pelvis. And that's what can create this kind of miscommunication and misfiring of like, oh, I'm really kind of tight in my hips and I need to stretch my hamstrings or I need to stretch my hip flexors. And what actually would probably benefit people more is learning how to unload some of these other areas and learn to load these areas that we need to work in the hips more.

Finn Melanson [00:10:21]: I'm sure there are some listeners out there that are thinking like, so what? Why should I care about the hip region when it comes to the whole chain of human motion? So maybe talk for a bit about the consequences of a lack of mobility, a lack of range of motion in this area tightness. What are the consequences as they relate to running efficiency and performance if you're not correctly and consistently addressing this area of the chain?

Guest [00:10:48]: So if we're not getting proper communication through the hip joint, that's going to then influence again where we're getting that movement from the body doesn't stop moving. So if we're not utilizing the hip as it was meant to, in a forward and back motion, a side to side motion, or a rotational motion, your body's going to figure out a different way to do that. And that's either going to happen through your lower back, that's either going to happen through your knees or your feet. It could even happen with how people are rotating their shoulders or using their neck muscles. So it can go all the way up or all the way down the chain. And so you do need to focus on, one, making sure that you do have mobility, but you have strength through that mobility to control that range of motion as well as you're running. And the analogy that I give to people when they're experiencing maybe some knee pain and it's maybe because of the fact that they either don't have enough mobility or they don't have enough strength in their hips is if you're in a baton race and you're running around a track and you have four people kind of at different locations at the track, like a four x one. If that person in the initial four x one doesn't hand off the baton as smoothly or drops the baton, then that kind of stops the next person from being able to run forward and then pass on the baton from there. Yeah. And then that whole chain of effect is then broken. The communication, the ability to efficiently finish and have a smooth contraction through the entire lower limb is gone because we haven't been able to pass off that baton. And that, like I said, can happen with the hip communicating down to the foot. It can happen to the foot communicating up to the hip. The body is super efficient in terms of how it will drive that motion. And it's going to get it done, it'll figure it out, but it's not going to be the way in which the communication should have happened.

Finn Melanson [00:13:00]: So many questions off of this. I think one of the first things just to maybe reinforce this with the listeners and the viewers, when you think about the hierarchy of important areas in the human kinetic chain to address are the hips because they're higher up in the chain, most important to address versus going down the chain to quads, hamstrings, calves. Does this influence everything below it, or how do you think about that?

Guest [00:13:26]: That's a good question. So when I work with people, I do find that it's easier to start closer to your core, closer to your trunk, and improve the communication there because thinking about it in this way, it's a lot shorter of a distance for your brain to communicate from my head to my hips than my head to my feet. And so I wouldn't say one is more important than the other because it really depends upon where the issue is truly lying. Like I said, some people's hip issues can actually be resulting from poor proprioception and awareness in their feet. But I find it easier for people to start to gain that intention and awareness working at your hips first because it's a shorter communication span between your head to your hips.

Finn Melanson [00:14:25]: Got you.

Finn Melanson [00:14:27]: Okay. And yeah, it's interesting. This is maybe a self serving question because I know that my massage therapist tells me all the time I need to work on my deep hip rotator muscles and that this is a significant problem area for me, but for anyone else out there that maybe hasn't dealt with a hip injury yet. But there could be an underlying issue there. What are some of the warning signs or symptoms of, at some point in time, hip dysfunction that they should be aware of in prehabbing or treating well ahead of time to get ahead of?

Guest [00:14:58]: So, I mean, if you're feeling one inefficient in your stride, there could be some underlying things happening there. It's so hard to say because, again, it's really dependent upon the individual. But if you're feeling inefficient in your stride, if you feel like you're struggling to recover prolonged soreness in your hips, in your lower back, or even in your core, that could be a sign. Or having infrequent knee pain or foot pain, that could also be a sign that there's again something happening at your hips and you want to get that checked out or you want to start to be aware of that. But definitely prolonged soreness would be one of the things that would kind of let you know that, all right, if you're feeling this, especially if maybe you're doing a track workout. Track workouts require a lot of rotation that requires a lot of your external and internal rotators of your hip to work really well. And if you're being kind of thrown on the track for the first time and you don't have that stability and control to kind of work with the force of that torque that happens with running around a track so many times that's where you can then end up again seeing knee pain happen or foot pain happen or just prolonged soreness happening.

Finn Melanson [00:16:16]: So in a lot of case, or I shouldn't say in a lot of cases, but in some cases, if you're having knee pain, like runners knee, for example, is that symptomatic of more like a hip issue or an it band issue? It can be okay.

Guest [00:16:29]: Yeah, absolutely. A lot of the people that I work with that have knee pain, again, I attribute that to the knee is an efficient joint. The knee is really good on essentially assisting in movement and helping us progress and move forward. And it can take on a lot of load, but it's not meant to do that forever. And so eventually it gets tired and it's like, I'm fed up with this. I don't want to be doing as much work as you're making me do. And that's when we start to essentially get the pain reception happening. And that can often be due to the fact that the hips are not maybe doing as much work as they should be in terms of, again, like your Adductors, your hamstrings glutes, your abductor muscles, and that's putting more load through your quads that are really strong and then essentially putting more force through the front of that knee.

Finn Melanson [00:17:27]: Maybe one last question on this particular topic. For folks like myself that may be dealing with something on the horizon. How do you differentiate I'm worried how do you differentiate between normal muscle soreness or temporary limited range of motion in that area versus the onset of some more serious hip issue?

Guest [00:17:51]: So when you're looking at muscle soreness versus pain, so there's obviously going to be a normal level of discomfort when we're training for something. And that, again, your specific level is going to be different than my level because of training loads and training ages and things like that. But when looking at how to differentiate pain versus muscle soreness, one muscle soreness should probably only last between, at the maximum 48 to 72 hours after a specific workout or things like that. It should not be lasting for five days, six days after you do a workout, and it should not be building either. Movement actually should help reduce it and help it actually improve. When maybe you're kind of experiencing the initial onsets of pain or potentially an injury or an overloading issue, that's when you'll often notice one. The pain or discomfort will linger for longer periods of time, and it won't get better with certain movements. Certain movements will trigger it because of the fact that there's again a loading and a miscommunication happening during that type of movement and that doesn't mean we avoid that movement. We just need to figure out how to train that movement at the level that your body is receptive to it at that time and that's where working it with a professional can help you with that. The other big difference between muscle soreness and pain is pain is typically going to be a bit deeper, sharper and more intense. Where muscle soreness, again, it's going to be achy, it's going to be a little bit uncomfortable. But the more that you kind of move and if you're waking up with muscle soreness, you kind of move around, you stretch, you walk around. It should kind of dissipate relatively quickly and you may only feel it kind of when you go into certain movements that you're like, oh, I worked that muscle yesterday when I did strength training or something like that. But it shouldn't create a sharp or deep type of pain.

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Finn Melanson [00:21:11]: I think this next question hopefully sets up the rest of the conversation in terms of actionable activities cross training, stretching, range of motion type stuff that runners can do to improve this area of their gait. But can you first discuss the role of flexibility in general range of motion in the hips and its impact on running mechanics? Because I think there are a lot of people out there that have heard about the importance of stretching or if not stretching, mobility exercises or if not mobility plio exercises but they're concerned that if they take any of those steps it may somehow compromise stability or spring or power in their running. So how do you think about all that?

Guest [00:21:52]: So when it comes to stretching I am not a huge and this is my personal preference, this is what I've seen benefit not only myself but also other runners. I don't see a huge benefit to static stretches to actually get benefit from static stretching you need to hold it for a very long extended period of time. Like I'm talking like a minute and a half, couple of times, like three times to really see any physiological changes. And most people are not going to be patient enough for that. No one's going to sit in a hamstring stretch for a minute and a half, three times, multiple times a day at that to really get the quote unquote physiological benefits, if you can call them that, from doing that type of stretch. Now that being said, there are some people that really love stretching. And I'm all about do you, if it makes you feel good, if it makes you feel happy and all of that, unless it's something that we're determining that is actually increasing your pain and you're not realizing the connection there, go for it, stretch all you want. But most runners are like, I don't really like stretching, so do I have to do it? And my answer is no, you don't have to do it. There are other manageable ways to actually stretch and create mobility. You can create mobility through strength training exercises as well or you do active stretching. So I find more of like the dynamic warm ups that you traditionally see in running. Those are super helpful. Those can be helpful in loading the muscle through length. And that is more simulating of how we actually use our muscles on a daily basis because we never actually use our muscles in stretch. Our muscles lengthen and load so they're still contracting but over a lengthening period versus a shortening period. They never just stretch and don't contract. They are always either contracting in length, contracting in a shortened position, or contracting in an isometric position where there is no length change. So stretching statically doesn't really relate to running in that way where we're not using our muscles on a stretch type of stimulus. So that's where I kind of focus more on lengthening through load, teaching people how to create that mobility in the muscle and go through the full capacity range of motion of that muscle or of that joint without stretching. But we're doing it with using weights or with using pliometric exercises. Even you can stimulate those same effects with those quick kind of movements as well.

Finn Melanson [00:24:38]: Okay, so yeah, just to summarize that back, you're more in the camp of like if you want to improve mobility in this area and range motion in this area, first look towards strength training, first look towards pliometrics, stuff like that. And optional on the table is stretching. But that's not something you would typically advise if people are open to what you think are the best practices.

Guest [00:25:01]: Yeah, again, if people really want to stretch, go for it, like have a ball. It's not going to necessarily hurt your training. But I wouldn't say that it's going to be the thing that's going to make or break or help you perform your best or feel your best. And then when I say kind of learning how to strength train and go through full range of motion, it's like learning how to do a squat all the way to the ground. Can you squat all the way to the ground, keeping your heels on the ground and having the proper form, having the proper kind of body alignment in that full body movement going up and down, and get the proper co contractions that are necessary. Because if you're doing that correctly, then you're loading your hips, you're going through your hips almost full range of motion in that mobility. Same thing with like a deadlift type of movement. That would be another movement that you're actually working on, some hip mobility and range if you're doing it appropriately. And a lot of people actually struggle with both of those movements and controlling those movements through the full range because they don't know how to lengthen through load and not relax their muscles, but load through length.

Finn Melanson [00:26:16]: So interesting. It makes me wonder, with the clients that you work with, for example, do you find that if they come from a certain background, perhaps like the ball sports, like football, baseball, basketball, where there maybe was some lifting, weightlifting? In their background that they are better suited for running in a sense, because they have those fundamentals were a part of their earlier lives versus runners who maybe didn't have that weightlifting background or that emphasis on range of motion. How do you think about that?

Guest [00:26:43]: Yeah, I wouldn't say that. I think they have different issues. So if we're talking about ball sports again, most of those sports maybe aside from soccer here in the US. They don't require as much long distance running, so they're more speedy sprint, real power movements. And with that you're going to create actually more springiness. And so you're going to see kind of like when those type of people run, they're very bouncy and they have a lot of flight when they're running where you can kind of see it in newer runners that maybe don't have a background in any strength training or anything like that. When they land, it's almost like they're collapsing into the ground and they're falling into the ground because their body can't create that pretension that happens before we land to allow that spring loaded movement. And so, yeah, I would say that those people that do have a more team sport where strength training is promoted more and it's not, as I think, demonized like, a lot of strength training and running is like everybody's afraid to get bulky when it's actually physiologically impossible to get bulky when you're an endurance runner. But I think in those sports where it's promoted a bit more and it's also a part of the culture consistently that's where they do sort of benefit into transitioning into endurance sports. Maybe not easier, but they can without maybe as many risks because they have that very strong base of strength training leading up into them going into endurance sports.

Finn Melanson [00:28:26]: Fascinating. Okay, yeah. This is really insightful for me to close the book on the stretching piece, because I know, especially in my case, I had followed the advice of, like, if I do, like, a couple of pigeon stretches, for example, it'll release some pressure on my It bands or my knees. And that'll be not necessarily a quick fix. But if I stick at it, it'll improve range of motion in those deep hip rotators and just give me more strength there. But you're saying there are probably more high leverage activities that I could be doing to fix those problems.

Guest [00:28:58]: Oh, absolutely. And I'm not above a good pigeon stretch. I have a form of a pigeon stretch that I give a lot of my clients that they feel great in and they absolutely love it, and I do it and it feels great. You're getting a really deep opening of the back of that hip capsule, and it feels good. And you can actually use active breath, which then makes it more of like an active movement to actually stimulate some of that lengthening and shortening of those fibers using just like, your breathing mechanics. But in terms of running, yeah. When we look at the demands of running, there's probably more high level movements that you could incorporate into your strength training routines that are going to simulate you. Opening up the back of that hip capsule. Opening up those external rotators learning to load those external rotators through length that simulate more of the demands of running versus just holding a pigeon stretch for an extended period of time.

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Finn Melanson [00:30:53]: Okay, so with this next question, of course, there's the caveat that proper form is important, and maybe we can link to some videos based on what you recommend in the show notes. But touching on strength training, are there any specific strength exercises that you love to give your clients that really have a good impact on hip health?

Guest [00:31:14]: So, obviously, like the two ones that I've already spoke about, I really love a good front squat. Front squat really helps to teach people how. To get a proper canister position. And what I mean by that is stacking rib cage over your pelvis, getting your core on, and keeping that kind of like neutral position in the spine. And there should be curves, it shouldn't be flat. But having that access then helps you to be able to fully lower down into a low squat. And your hips have to move through internal rotation, starts in external rotation, moves to internal rotation, and then actually back to external rotation for us to fully drop down into a full squat. And so that's actually very beneficial for a lot of runners to teach that one how to engage your core as well as move through a full range of motion without maybe hinging your hips back behind you. So a lot of runners will end up kind of like not letting their knees go forward and hinging their hips back. I teach essentially the exact opposite. I get people to stack themselves in that front squat position. I usually elevate the heels to make it a little bit easier for people to have more range of motion. And then I teach them to get their knees to go over their midfoot and even their toes so that their hips can come straight down. And that's one of probably my favorite exercises that I love to kind of teach people. And you can lift relatively heavy with that as well. You can get eventually leading up to being in a gym under a bar with some plates on it to lift and load really heavy, especially during the off season of training. And then teaching people how to hinge and deadlift. That is also a super beneficial movement in terms of opening up the back of the hip capsule. So if I've kind of caught on that there's something going on in terms of your external rotators that we want to access those more. And if you learn how to then again, keep that canister position pelvis and rib cage in a neutral position, core engaged. Not bracing super hard, but core engaged. And then learning how to kind of tilt your torso forward, pushing those hips back as far behind as you can while keeping your knees just slightly bent, that's going to then open up the back of the glutes. And that's the way that I primarily focus on teaching people first how to engage their glutes, because a lot of the exercises out there teach you to close your glutes off. So clamshells are a really popular one. Even side bandwalks. All of that is kind of pushing the knees out, rotating the legs out, and that shortens that entire back chain. It's not a bad thing in theory, but if we're doing that all the time and we're never doing the opposite motion of keeping the knees in neutral and letting the hips go back and open up the back of the hips capsule, that's, again, where we can get some unnecessary tightness or biased in certain muscles. And so by teaching people to hinge, that naturally allows them to open up the back of the hips and allows them to lengthen some of those rotator muscles, lengthen the glutes a bit more, load the glutes. And if we can lengthen and load, then we can use that to then contract harder and push ourselves forward harder to have a better propulsive movement.

Finn Melanson [00:34:37]: In running, I probably shouldn't be lumping all of these together, but when you think about foam rolling or the trigger point tools or massage guns, do those have a place in your programming for improving hip health?

Guest [00:34:53]: Yeah, absolutely. For those that are experiencing acute pain, definitely using soft tissue work in terms of whether that's self massage or using a foam roller or using a lacrosse ball massage gun, all of those things can be super helpful. I always tell people that it's helpful to a point. So we want to use it. We want to essentially use it to help us kind of tolerate more movement and not maybe have as much of a negative kind of perception of pain if we're dealing with a very high level of pain at that time. So we want to use that to kind of help break the barrier. But then we want to learn to, again, load through movement from that point. But absolutely, those tools can be helpful. It's just it only gets you so far where I think in the fitness world, in the traditional rehab world right now or not right now, it's starting to change. But in that world, it's all about foam rolling, stretching, soft tissue work. People think that that's what they're going to just go to physical therapy and get. And for me now, working for myself and I get to kind of control that a bit more. I'm like, no, physical therapy in the name means that you're going to get physical, you're going to move, you're going to load, you're going to do some exercise here. We're not just going to do some soft tissue work and send you on your way.

Finn Melanson [00:36:22]: In your opinion, do those soft tissue tools, do they belong in a warm up routine, a cool down routine, or some area separate in your day? How do you think about that?

Guest [00:36:33]: Again, it depends how you use them. So again, making this a little bit simplistic for listeners. If you're going to use a foam roller and you're going to use it before you go running, you would want to use it in a way that you're kind of like going quickly over the muscles so you're not rolling slowly. You're kind of going really rapidly back and forth over a very kind of like short distance. So if we're doing the quadriceps, maybe you're doing only your lower quads and you're going really quick over that, and then you move up to the middle kind of meteor portion of the muscle and then you're going quickly, quickly over that. And then you're going up closer to your hip joint, quickly over that. That's going to create that quick kind of rolling motion. And you can do this again even with soft tissue, with using a tool, with using a ball or your hand, you're going to stimulate your nervous system with that. And those quick motions are going to create just more kind of alert fibers to kind of create quicker contractions. And so that's where that can be helpful to almost warm up for a run. Because you're stimulating your nervous system. You're waking up your nervous system before you go out and run using those type of tools. After you run, you're cooling down. So you want to go slower. You want to relax everything. You want to allow things to just kind of like, calm down a little bit. So instead of going quickly over those three different portions of the quad that I talked about, you're going to go slower, you're going to take more time. And usually this is where people feel a little bit more discomfort because we're putting more pressure on the muscle because we're spending more time in each section. But that's where you'll see kind of more relaxation happening if you're going slower over that period of time.

Finn Melanson [00:38:18]: Got you.

Finn Melanson [00:38:20]: I know we just started to talk about warm up and cool down routines. I'm really fascinated to learn what we can do inside those routines that directly benefit the hips. So if you're thinking about getting ready for a run, that like 30 to 60 minutes before run, or even just the moments before the run where you're at your car, maybe doing a couple dynamic stretches or something, what routines or what activities would you do pre run, for example, to get your hips ready for the task at hand?

Guest [00:38:49]: So I really love there's an exercise that I use with the foam roller for people, and I really love it because it's always surprisingly hard for people, but it really gets your hamstrings in particular awake and it helps get your posterior chain awake. So you're lying on the floor, you're getting into bridge position, and you put the sole of your feet, the arch of your feet on a foam roller. If you then bridge your hips up and then with your feet on the foam roller, you quickly roll back and forth, like very rapidly. That's going to require your feet, your calves and your hamstrings all to contract really quick, shortening and lengthening really quick. A lot of people cramp with this exercise. It's very normal. It's also very normal for that foam roller to roll away from you. A lot of people get frustrated by that. But it's normal for the roll roller to go away from you. But that's a really quick and dirty kind of exercise on the ground that most people can do. If you're just starting out and you're really cramping up when you're doing this exercise, even starting out and doing three sets of like, 10 seconds of those rolls really is going to benefit you and wake up that nervous system before you go out for a run.

Finn Melanson [00:40:00]: How about that's? A really good one. I have not tried that one yet. I will on tomorrow's run. How about in the cool down routine? What would you incorporate into the cool down routine that directly targets the hips?

Guest [00:40:11]: I just tell people to walk. I love walking as like, a cool down. I think it's something that's super underrated, but I tell people to walk. I tell people to maybe do some breathing exercises. So a lot of people really love kind of getting into like a happy baby pose or a rock back position and breathing into your hips. I find that that can be really gentle. But if you're really short on time and you can't get down on the ground, you can't access things. Just walking and keeping your eyes up, looking around your environment, letting your arms swing, that's going to naturally just kind of create a little bit of rotation in your torso that's going to create rotation in your hips and that can be kind of, again, really soothing. The main purpose of a cooldown is just to kind of like, help start to promote blood flow to these areas that we just worked out really hard to help reduce metabolic waste. So we don't need to be doing anything intensive. It's just about starting to kind of cool down the body.

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Finn Melanson [00:42:48]: A couple of things I want to talk about before we close up. We had Kelly and Juliet Stirrett on the podcast a while back, and they're big into mobility supple. They wrote the Supple Leopard, all that stuff. And Kelly has this test that he likes people to do where you're sitting on the ground cross legged, and then he wants to see if you can stand up from that position without using any assistance, like putting your hand on the ground or kind of wavering back and forth to shift your weight upward. And I'm not sure if you buy into that test, but are there any tests that you like to have runners go through to provide, like, a baseline level of their current strength in that area or range of motion that they could even self administer?

Guest [00:43:33]: Yes. So the two things that I probably test to see kind of like where people are at in terms of their mobility, and then do we need to work on mobility or do we need to work on strength is to something super simple like toe touch. So just bending down to touch your toes and then well, let me talk about that one first. So bending down to touch your toes, and you want to unlock your knees. A lot of people try to lock out their knees and come into full extension at the knees. I tell people to just soften the knees a little bit and then show me where you can go. If you can't touch the floor, okay, then we have some length that we need to kind of regain in that posterior chain. Whether that's happening in the foot, the calf, the hamstring, the glutes, or even the back. We need to kind of figure out how to create a little bit more length through that range of motion so that you have more opportunity for movement. Or if you can get down and touch your toes all right, then you have a pretty good optimal length there through the posterior chain. We probably don't need to be doing any stretching. Let's just make sure that we can do that efficiently, load through the full range of motion and continue to work on strength. A lot of runners, I would say, like, 95% of the runners that I work with, they feel like they're super tight, but then they can palm the floor, and I am one of them. I don't feel super tight all the time because I know the exercises to do, but I can palm the floor every day, all day. And that shows me that you have a ton of length in your posterior chain, and having a ton of length isn't a problem. But can you control it? Can you actually move through the full range of motion when you're running and control that length. And that's where most people then don't have that kind of stability side of things. And then the next exercise that I have people do is, again, bend down, touch your toes. If you can't touch your toes, grab your ankles. But if you can touch your toes, grab your toes. And then try to squat down with your feet in a neutral stance so about hip width apart. And if you can squat all the way down and get your butt to the ground, then essentially you again, you have a good amount of range of motion. So if you can touch the floor, you can get your butt all the way down. You have a ton of range of motion that we need to make sure that you can control. And we need to make sure that there's a good amount of stability there. A lot of people get stuck around, like the 90 deg range where they can't get their butt any lower. And usually that means that they're probably lacking in some form of mobility for internal rotation at the hips or they're lacking in strength to get their body weight all the way down. And that's where we want to work on hamstrings, we want to work on the inner thigh muscles, we want to work on lengthening those external glute rotators in the back to be able to create that full range of movement. But that's a really kind of like, easy test for people to kind of see, all right, how much range of motion do I have and then can I fully control it going into a full squat? And by locking your hands and your feet together, that forces the movement to happen solely through the lower limb and through the trunk and the core to see how we can control that together.

Finn Melanson [00:47:03]: I'm not sure if there's a single right answer to this question, but I'd love your perspective when you think about all of the things that cause range of motion issues, hip health issues and runners. Is it the equipment that they're using? Is it the lack of prehab or rehab that they're doing around the activity of running? Is it the surface? What is the most common reason you see in your clients for hip health issues?

Guest [00:47:33]: I mean, I would say the most common not just hip health issue in runners, but the most common reason that we see issues happening in runners is because of people not prescribing, too progressive, overload, and giving themselves enough time in terms of proper training to recovery, period, doing too much too quickly, not understanding. Like a lot of people think that they can just go out and go for a run. And there's a lot of strength requirements that you should be able to do before you go out and go for a run. You should be able to hop on 1ft for an extended period of time. That's essentially what you're doing when you're running. And there's a lot of people that get really tired with that after 30 seconds. And if you're doing that for 30 seconds, how can you go run for multiple miles or multiple hours? And that's, again, simplistic kind of viewing of it, but that's where I see a lot of people getting themselves in trouble, is not progressively overloading properly. The other thing is, in terms of what we are required to do on a daily basis, we're driving more than ever. We're sitting more than ever. Me and you are sitting right now talking on a podcast. So we are just not moving as much as we were necessarily designed to do. And sitting isn't inherently bad. Again, it's been something that's demonized I'm not someone to kind of prescribe to that kind of clickbaity, oh, you shouldn't do this type of thing. I'm like, no, if your body was designed for it, you probably can do it. You probably just don't want to do it all the time for hours and hours on end. So sitting for hours on end at work is just as bad as standing on hours at work. Your body was designed for movement. Our body was designed to constantly have these lengthening contractions and shortening contractions. And when we're in one position for a long period of time, we're essentially just forcing one area to constantly be shortened while the other area is going to be constantly lengthened. And that's where you're going to just get more of these biases of these muscles that are already leveraged to begin with and are going to just kind of kick on and be like, all right, I can do more of the work because it's easier for me to do it that way.

Finn Melanson [00:49:50]: Wow, okay, cool. Maybe two more questions. And thank you so much, by the way. This has been incredibly enlightening for me in particular, but I'm sure the rest of the audience as well. Is there anything that you recommend or that you would intervene on when it comes to running gate? Like, if you were going to do like a gait analysis on a runner, if they were to come and see you in person, maybe even virtually, is there anything that you like to tinker with there to create fixes for the hip?

Guest [00:50:21]: Okay, I could go on a whole tangent on this on its own. Again, this is going to be completely different from probably what every other physical therapist and runner rehab specialist will probably say out there. But I don't correct form. I don't do that because I believe however you're running right now is probably the way that you are most efficiently running right now. Could it be better? Maybe? Probably. We can work on strength movements to kind of improve that efficiency, improve those co contractions to naturally improve form over time. But it's kind of I think people try to correct form and running in the same way that we correct kind of like skill sets and running is more natural than that. It's something that we were naturally built for and everybody's going to have a little bit of a different stride. The one thing that I would say that I do try to work on with people is just making sure that they're not overstriding and making sure that they're landing underneath their base of support. I do find that that helps with them having the ability to co contract through multiple muscle groups a lot easier. And you can kind of just think about it really simplistically. If you're holding a water jug with your arm extended and you try to do a bicep curl, that's going to be a lot harder than you starting off with your elbow slightly flexed. If you have your elbow slightly flexed, you're going to have more leverage to start and you're going to be able to get that water jug up to your shoulder a lot quicker and a lot easier. Same thing with running. We want to be putting ourselves in a more leveraged position, and that's what improving running form and running efficiency is. It's just improving the leverage that our muscles have to work together to improve form over time.

Finn Melanson [00:52:14]: Okay.

Finn Melanson [00:52:16]: One thing you said right before that was there should be this variety in all of our lives. Like there should be an amount of time spent sitting, an amount of time spent standing. There should be like a variety of movement positions throughout the day, all that kind of stuff. And I know that we talked about strength training earlier in the conversation, but are there any other cross training activities where if there was enough time in the day, if you could prescribe it to one of your clients, you would give it to them like swimming or cycling that would benefit this area of the runner's body?

Guest [00:52:49]: I have a lot of runners that will use cycling to help their running and I think it is, again, something that a lot of runners could do more of. And they're going to get the same aerobic benefits from cycling as you do running. Your body doesn't know the difference, first off, but you're going to get a lot of the similar benefits of aerobic capacity training or even anaerobic training when you're using a cycling machine or you're going out and you're riding your bike because it doesn't require as much how do I want to say this? Doesn't require as much neurological fatigue. So when we're running, the bouncing and the vibrations that go through our body can actually be very fatiguing for our body, where when you're on a bike, you're sitting still, but you're still pedaling your legs and so you're still going to get the aerobic benefits, but you're not going to get as much vibrations through your body. So it's not going to be as neurologically fatiguing in comparison to running and the other thing that you can work on when you're on a bike is I get people to work on kind of that quick turnover and making sure that they're getting that pull through the pedal. So a lot of people pedal their feet like pistons and up and down, up and down, up and down. And that's what I think a lot of people do when they're running as well. They think of just moving their legs up and down. And I try to get them to learn that it's actually supposed to be a circle, that our legs are going through this circle. And when you're on a bike, you can learn that. And you can learn that pull through the pedal. And that pull through the pedal is going to create that intention through the foot, the calf, the hamstrings, the glutes, everything, so that everything is working together. But I'm also a big proponent, I just talked about this in my own podcast where I'm a big proponent for just like promoting variety and cross training. So if a runner wants to go and play softball or play soccer or do any other sport, we as coaches should be out there promoting it and not fear mongering them into thinking that like, oh, you could get injured, be careful, or don't do that because you could get injured. Let's have them have variety, let's have them have fun because no one's getting paid to do this unless you're a professional. And we deserve to have a little play and fun in our lives. There's so many things that we have to take seriously. Our sports should not be the one thing that we're creating more stress with.

Finn Melanson [00:55:19]: That resonates with me, I know, and probably with a lot of listeners because whenever I have a friend who will say something like, hey, I have a softball league game tonight, let's go play, or we have a rec basketball game going on this afternoon, let's play. The first thing that comes to mind is I have not been in any of those movement patterns. I have no lateral motion familiarity, at least in the last ten years since high school or college. If I go and play in that game tonight, I'm going to tear an ACL or do something and just be out of running for forever. So I'm glad that you were able to kind of, to some extent, obviously.

Guest [00:55:55]: There is some risk. We can't say there's not any risk when we're trying something new, but it's about one take it easy if you're going to go and play for the first time in maybe ten years. But, hey, maybe that's one of the things that you could benefit from in terms of getting more of that lateral movement back in your life. That's going to help your hips, that's going to help your stability. And obviously, if we don't train it, we're not going to be prepared for it. So slowly incorporating it back and maybe just being as cognizant as we maybe should be with our running as we do with these things, knowing our limits, being like, I've played like maybe how many quarters are in a basketball game? So you've maybe played like maybe play two of the four quarters and start out that way versus trying to play the entire game type of thing. You can see that I've never played basketball in my life, but maybe starting out that way, where you're bringing yourself back into that and allowing yourself to have again, that variability of movement, but you're not kind of pigeonholing yourself into it is only acceptable if I come back at 100% because I used to be at 100%.

Finn Melanson [00:57:05]: Awesome. Well, Lauren, it has been such a pleasure to have you on the show. I personally learned the town. I know everyone else did as well. I did mention that the first time you were on the show last year. We'll link to that in the show. Notes I always like to leave the guests with the final word. Are there any episodes for your own podcast that you've done this topic or any final thoughts you'd like to leave the listeners with before we go?

Guest [00:57:28]: Have more fun. I think that is something that I have more fun, have more flexibility in your training and have more grace for yourself in your training. That's something that, as a coach that I have learned needs to be incorporated more, even something that I have to remind myself. And I think, again, we take ourselves so seriously all the time that we need to remember that we're doing this for the fun of it. We probably started because we really enjoyed it and we don't want to lose that enjoyment in the long term. So by giving yourself that flexibility, having more fun, being more playful with it, and giving yourself more variety and grace in what you are able to show up for, you're going to build a more resilient you in the running journey that you're on. But you're also just going to enjoy the journey a lot more and you're going to be absolutely like pun intended there.

Finn Melanson [00:58:39]: Thanks for listening to the Run to the Top podcast. I'm your host.

Finn Melanson [00:58:42]: Finn milanson.

Finn Melanson [00:58:43]: As always, our mission here is to help you become a better runner with every episode. Please consider connecting with me on Instagram at Wasatch, Finn and the rest of our team at Runners Connect. Also consider supporting our show for free with a rating on the Spotify and Apple podcast players. Lastly, if you love the show and want bonus content, behind the scenes experiences with our guests, and premier access to contests and giveaways, then subscribe to our newsletter by going to Runners Connect. Net podcast. Until next time, happy trading.