When trying to understand how strength training can prevent injuries, we need to create a roadmap of sorts. We need to start at the beginning. This means analyzing trends, or, more specifically, discovering the differences between strength in certain areas of the body and injured areas vs. healthy runners.

Once we have this information, we can then start to narrow down this data and see how it contributes to different types of injuries, so we can determine whether or not there is indeed a link between strength, or lack thereof, and running injuries. Finally, we need to find out if improving strength in the specific areas known to contribute to running injuries actually helps get you healthy and keep you healthy.

So in typical Runners Connect fashion, we’re not going to just guess at this info. We’re going to look at the actual scientific data. So let’s start at the beginning. What differences do we notice in the strength of healthy runners versus injured runners? The first study we’ll look at examined hip strength in runners visiting an orthopedic clinic for injuries.

30 runners who had various hip and leg injuries had their hip strength tested in all six directions of motion. Compared to a control group of recreational runners who were healthy, the injured runners had weaker hip flexors and hip abductors on the injured side, while their adductors were stronger on the injured side.

The healthy runners displayed no side to side differences in muscular strength. Interestingly, despite the influence of muscle strength imbalances, No relationship was found between the injured side of the runner’s dominant leg. Okay, so this study starts to shed some light. Hip strength appears to be a major difference between healthy and injured runners.

So now let’s look at and let’s examine some studies that test hip strength in relation to specific injuries to see if this finding can be applied somewhat universally. In 2003, a group of researchers evaluated 15 women with runner’s knees and compared with healthy, age matched control subjects. The researchers found, again, that the injured runners had weaker hip abductors as well as weaker hip external rotators on their injured leg compared to the control group.

In a follow up study to the first paper we looked at, Nemeth et al. used a better designed procedure and demonstrated that injured women were indeed weaker on their injured side, as well as being weaker overall in measures of five of the six major hip muscle groups compared to healthy runners. Okay, so thus far we’ve looked at only a few types of injuries, most prominently runner’s knee.

But we need, what about more common injuries like IT band syndrome or even shin splints? How can shin splints be related to hip strength? A pair of studies released in February and October of this year were published by a team of researchers based in the University of Belgium. The researchers followed 86 women who were enrolled in physical education classes at the university.

The studies used both a prospective design, meaning they measured the biomechanical variables of interest at the beginning of the study. This is important as it rules out any changes in mechanics that occur because of the injury. Thus, the subjects who would go on to develop medial tibial stress syndrome or shin splints couldn’t be compared equally to those who did not.

The first of the two studies looked specifically at hip abductor and external rotator strength. The 21 subjects who got shin splints had significantly worse hip abduction strength at the beginning of the study, proving that the use of hip strength testing and screening for shin splint risk. The second study collected data from the same population of female physical education students as the first study.

The findings showed that the women who developed shin splints had significantly more motion in their torso and hips when they landed and pushed off when compared to those who stayed healthy during the study. Wow, so even shin splints can be caused by a lack of hip strength. It seems that we found the culprit.

But before we jump to any conclusions and start doing every strict hip strengthening routine under the sun, we need to determine if improving hip strength will actually prevent and treat these injuries. That’s where an older study with a more innovative approach comes into play. In this study, injured runners had all been diagnosed with IT band syndrome.

Like the previous studies we’ve looked at, these researchers found a significant difference in hip abductor strength between the 24 injured subjects in Healthy Controls. However, this study went a step further. It followed the subjects through a six week gluteomedius strengthening program. The gluteus medius is the main hip abductor and external rotator, and it’s implicated in hip abduction weakness.

When doing this, all but two of the injured runners were able to return to training after the six week hip strengthening program had concluded. So now the question is, what hip strengthening exercises are going to be the most effective, both at targeting the right muscle groups and not wasting your time?

To do this, we need to do some follow up steps. First, we need to examine what muscle groups we need to target to help reduce the chance of injuries. Then we need to find the exercises that best target these muscle groups and avoid any that could strengthen the wrong areas by mistake. So once again, in typical Runners Connect fashion, we’re going to not just guess, we’re going to look at the research.

An illuminating study just published recently looked at the relative contributions of three muscles, gluteus medius, the gluteus maximus, and the TFL, to hip motion in 11 different hip strengthening exercises. These three muscles are of most interest because they have distinct and significant roles.

Gluteus medius is the main abductor and external rotator of the hip. The gluteus maximus extends the hip and assists with abduction and external rotation. The TFL is an abductor of the hip, but because of its positioning, it can also contribute to internal rotation. For the mer, according to John Fairclough and colleagues in the UK, a tense TFL, because it connects directly to the knee’s lateral side via the IT band, may increase knee strain and could develop into or exaggerate IT band injuries.

Therefore, the ideal hip strengthening exercises are those that maximize the recruitment of the gluteus medius and maximus while minimizing the recruitment of the TFL. These were characteristics studied by a group of researchers when they evaluated the 11 different hip strengthening exercises. Using EMG, a technique that measures the electrical impulses sent to muscles, the researchers monitored the muscle activation levels in 20 healthy subjects during, while doing these 11 different hip exercises.

The researchers found that the best hip exercises were clamshells, sidesteps, single leg glute bridges, and two variants, bent knee and extended knee, of quadruped hip extensions. These five exercises display a statistical significant difference in EMG signals in both the gluteal muscles when compared to the TFL.

We can also use this data from other studies to find more exercises that target the gluteal muscles so we can start to craft the optimal routine. So here’s a look at some of this data. So now that we know an optimal injury prevention strengthening routine will consist of exercises that target the gluteal muscles and minimize the recruitment of the TFL.

A great start to creating your own routine would be a series of clamshells, side steps, single leg glute bridges, bent knee and extended knee quadruped hip extensions, side lying leg lifts, and single leg deadlifts.

I’ll be sending you the next video in our four part series in a few days. In that video, I’m going to talk about the direct performance benefits of strength training, and the specific routines that help the study subjects and our own athletes achieve these results.

Before we get to that video, however, I want to ask you a favor.

Please start implementing this injury prevention hip routine now.

Whether you use the exercises above or you purchase our routine, start adding the hip strengthening to your training right now. Don’t be the runner who hears the latest research and best ideas, ways to train, but doesn’t take action.

Seriously, the routine above takes 5 minutes total. Just 5 minutes and you can drastically reduce your chance of injury. So, stay tuned for the next video and get working on adding your hip strengthening exercise to your running now. I’ll see you then.