Following up from the last blog – foot flare – I want to go into more detail on the importance of preventing your external (lateral) hip rotators from becoming too tight. Hip rotators can easily become tightened, usually as a result of overuse or sitting too much throughout the day. 

Lateral Hip Rotators in Order of Importance – Warren Hammer, author of Functional Soft-Tissue Examination and Treatment by Manual Methods.

  1. Gluteus maximus
  2. Quadratus femoris
  3. Oburator internus
  4. Gluteus medius and minimus (dorsal fibers)
  5. Iliopsoas
  6. Obturator externus
  7. All adductors except pectineus and gracillis
  8. Piriformis
  9. Sartorius

These actions will cause your leg to rotate laterally causing the foot to pronate, or roll inward, more than it should at foot contact. Although the external rotation is often small, it is enough to cause a problem during running or even walking. Overuse and asymmetries are the top factors leading up to an injury, there are approximately 1,500 steps in a mile, if there is a mechanical dysfunction, given enough time something is bound to breakdown…

Side note – high arches and rigid feet often benefit from more of a cushioning or neutral type shoe.

Most people consider the piriformis to be the primary lateral hip rotator; however the Glute Maximus, and Glute medius, are also important lateral hip rotators. These muscles are also responsible for hip extension and abduction (raising the leg to the side). With runners, the hip rotators are often tight and the glute muscles are often weak – or in the least not activated.  The mixture of hip tightness and glute weakness can be a big problem for the hips, back, and especially the knee. 

Back to pronation – when the foot makes contact and rolls in, this helps absorb and dissipate some of the impact, which in turn reduces the force to the shin, knees, hips and back. This is good…

As the foot starts to make contact with the ground, the leg will drift in because of the weak glutes, and often tight adductors and the tight external hip rotators will allow foot flare. This combination will create a torque-like force for the knee at foot contact – creating instability at the knee joint. Additionally, this will accentuate pronation and cause further mechanical problem associated with “excessive pronation.” This is often where runners will begin experiencing runners knee, or discomfort on the inside of knee; this can also place extra wear and tear to the Achilles tendon, plantar fascia region, Iliotibial band, hips and knees.  

Over-striding will make this problem even more severe, but for now we will leave running mechanics out. Click here for mor information on injury free running.

The thing to remember is that it all comes down to balance. Excessive pronation can cause mechanical problems, but lack of pronation can also cause problems. Strengthening the glutes, and releasing the tight external hip rotators will help correct this aspect of running mechanics and help prevent overuse injuries.

Action Steps to incorporate into weekly workouts

  1. Stretch the glutes and hip abductors (lateral rotators).  Click here for picture and description from Hal Higdon’s website.
  2. Don’t neglect the glutes, it’s a powerful force producer.  Excellent resistant exercises such as bridges, single leg bridges, lunges and wall squats are a great place to start.  Focus on quality over quantity.

Matt Fitzgerald, in his books, The Cutting Edge Runner, and Brain Training for Runners  provides strength training workouts for the runner.  If you are not incorporating resistance training into your workouts, you need to read at least one of Matt’s books.  He is money…

Best,

Cole Ellis