"I don't know what I did, I have been fine for months and all of a sudden the pain started." I hear this in the office all the time and the patient's frustration is palpable and understandable.
The good news is that running injuries very rarely happen all of a sudden. The vast majority of injuries develop over time in a cumulative nature. There is a delicate balance between the amount of load that our bodies can withstand before the capacity to stay healthy breaks down. When breakdown begins to occur then pain, discomfort, and injury inevitably ensue. Usually we are given small warning signals that an issue is looming, but these are often mild aches and pains that seem to go away on their own and are discounted as normal parts of training. It could be weeks or months before a running injury rears its ugly head and wrecks your plan to set a PR that you have trained so hard to achieve.
If many running injuries take time to develop, wouldn't it be nice if there was a way to predict if you are at risk? Good news! The following are 5 tests you can perform on your own that will assess the mobility of various joints that need to be functioning properly in order to avoid some of the most pesky and common running injuries.
Standing Toe Touch
Can you bend forward at the waist and easily touch your toes? This is a basic functional movement that we all should be able to do. It reflects the overall health of your low back and hips. Although this test can vary greatly among people, if you are an active runner then it is important to have this movement.
Abnormal Test: You cannot touch your toes, you have increased low back or hip pain coming up or down, and/or you feel any tension into your calves.
Note: Did you feel tension into your calves? This is another topic of discussion, but if you did, I am willing to bet that you spend a lot of time stretching your hamstrings, but cannot seem to "loosen" them up. If this sounds like you, keep an eye out for our next blog post. Until then, consider stopping stretching your hamstrings.
Ever experienced Achilles' pain, shin splints, plantar fasciitis, or a stress fracture? These are all runners' worst nightmare. I hesitate even writing those words because I can hear the collective running community gasp as they read that first sentence. Having proper mobility in your ankles and strength in your lower leg and foot muscles is crucial to prevention of each of these injuries.
Put a ruler against the wall to the outside of your foot. Perform the test by place your big toe at the 1" mark. Keeping your hips square and your heel on the ground, bring your knee in contact with the wall. Continue moving your big toe back 1" until you can no longer keep your hips square and your heel on the ground.
Abnormal Test: Any range < 5" and pain or tightness into the calf, ankle, or foot.
Knee Flexion Test
Patellofemoral Pain Syndrome. Chondromalacia Patellae. Might as well be gibberish right? These two issues are so common in runner's that the medical community decided to make things easier and just call them "Runner's Knee." If certain types of knee pain are so common in runners, it would be nice to be able to test to see if you are at risk correct? Assessing the ability for you to flex your knee is a great way to start.
Test your knee flexion by standing up straight and grabbing your ankle until it comes in contact with your glute. This should be very easy to do and only provide a mild stretch in the front of the thigh.
Abnormal Test: You are unable to touch your heel to your glute and/or you have pain in the knee or thigh attempting the motion.
Kneeling Hip Extension
You are almost to the end of your race and can see the finish line. It is time to kick it up a notch and finish strong. At this point, you are exhausted, but nothing else matters. It is time to open up your stride and set that PR.
Stride length is everything to a runner and your ability to extend at the hips is a direct reflection of your ability to finish strong. Limited hip extension shortens your stride which can lead to issues in your low back, hips, or knees.
Test yourself by getting into the lunge position. Place a ruler at the front of your knee and lean as far forward through the hips without leaning your torso forward. The bony front of your hip should be 10-12" down the ruler.
Abnormal Test: Pain in the low back, hip, or a range of motion < 10".
Hip Flexion Test
We flex our hips when we run, squat, and bend. Weak and tight hips result in a compromised low back and your begin losing mobility in your hips. This loss of mobility can eventually lead to bursitis in the hip, IT band syndrome, muscle or labrum tears, and compensation injuries further down the chain. This is an especially important test for all you runners that spend the majority of you day sitting at a desk before you get your training in.
Test hip flexion by lying flat on the floor. Pull your thigh towards your chest until it touches your rib cage. Be sure that your opposite leg is relaxed and stays flat.
Abnormal Test: Unable to easily touch your thigh to your rib cage, pain in or around your hip or low back, or lifting of the opposite leg/bending of the opposite knee.
So, how did you do? Did you pass these tests with flying colors? Hopefully so. If you didn't, you likely had decreased motion or pain with more than one test. The most common reason for a loss of mobility in these tests is adhesion in your soft tissue. Adhesion is an accumulation of scar tissue, most often due to overuse, in soft tissue structures like muscles, fascia, ligaments, or around nerves. When present, adhesion in the soft tissue causes decreased range of motion, decreased strength, and pain. This is one of the most common problems in the body, is also one of the most overlooked, and is the most reversible.
If you experienced pain and decreased motion with some of these tests, it is not a questions of "if" you will experience an injury, it is more a question of "when." Don't ignore the warning signs and hope it gets better on its own. You owe it to yourself to find answers to your pain and discomfort. At Integrative Spine and Sport, Dr. Michael Heitholt specializes in diagnosing and treating soft tissue injuries. The goal with every patient is to find the problem, fix it as efficiently as possible, and equip each patient with some exercises they can do to prevent further injury.
Don't let pain and injury stop you, give our office a call at (317) 674-8800 or click below to schedule a consultation online. Thanks for reading and feel free to share to test your friends and family!