As we are slowly approaching spring, I am seeing more people out on the trails running and I know people are starting to train for spring and summer events. With that in mind, I wanted to share some insight into core stability and the importance it holds for running form and avoiding back, hip, knee, and foot injuries.
An important test we use in our office, called Trendelenburg test or sign, allows us to tell if a patient is missing core strength and stability, gluteus medius stability, and allowing their hip/pelvis to drop with each step. A positive Trendelenburg sign indicates weak gluteus medius on the standing leg, allowing the opposite hip to drop when the leg is lifted.
With each step, a person with weak gluteus medius muscles is stressing the glutes and the core, the hip joint, and then on down the chain into the knee and ankle. The joints further down the chain (knee, ankle, foot) have to absorb and compensate for the stress on the hip joint.
A key to returning to full function after discovering this weakness is working on strengthening the hip abductors. Clamshell exercises used to be given frequently, but there are much more effect exercises such as glute med. leg lifts.
The key here is in the photo you can see she turns her toe downwards before doing any leg lifting. So lying on your side, you will turn the toes down (internal hip rotation) on the leg you will lift, and then begin the exercise. Make sure your core is stable and your pelvis in neutral (neutral pelvis reminder article here) before you begin.
Gluteus Medius exercise:
- 10 large leg lifts (pictured above)
- 10 small leg lifts (6-12 inches lift)
- 10 forward circles
- 10 reverse circles
If you feel a burn before you are halfway done with this routine, try starting with 5 reps for each variation. Make sure to do both sides! While doing the forward and reverse circles, check in with your feet. Are they making jerky circles or squares? Focus on making as smooth a circle as you can, nice and slow.
This exercise should be done 2-3x/day, and may take several weeks of consistency before you notice any changes. This is not a direct core exercise but while doing it, you should make an effort to tighten those core muscles and really focus on a stable core while performing the exercise.
Happy trails!
Dr. Maya