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Symmetry, muscle imbalance and hip rotation

Dr. Mike Cerami will be available this Saturday, September 25, for a free, 15 minute consultation at Salt Lake Running Co.  Please call one of our stores to make an appointment.

Runners and athletes at any level usually want to go faster or go longer. It’s just human nature to want to do better.

The limiting factors to achieve these goals usually fall into 3 categories: Emotional (psychological, motivation), Chemical (bio chemistry, fueling, nutrition, and supplementation), or Physical (biomechanics, symmetry, distortion).

From the weekend warrior and casual runner to the ultra marathoner or Ironman triathlete, we all have limitations. Some are easier to resolve than others. It may only take a sunny day in September to provide the motivation to get us out on the road again. But pain and injuries are a different story.  Our initial impression when pain strikes might be to push through the problem, interpreting the body’s messages as a natural resistance to better performance. This may be true occasionally but more often than not, pain and injuries in the same area have a root cause from improper alignment which causes poor body mechanics. Interestingly these “cause” areas may or may not be in the same region as the pain.

One of the most common problems causing injuries to runners is muscle imbalance caused by hip rotation. Because the pelvis is attached above to the spine and below to the legs, rotation or distortion of one hip as compared to the opposite hip can affect everything above and below the pelvis; from IT band pain, psoas muscles tightness, knee and ankle tracking, lower back pain and of course the hip or SI pain.

Long term bio mechanical distortion causes structural adaptation over time which leads to anything from asymptomatic subpar performance to increased injuries and frustration. Proper structural alignment saves valuable body energy, reduces inflammation, and improves efficiency which means you’ll be able to push harder with fewer injuries, recover quicker and extend your running career.

How do know if you have muscle imbalance and hip rotation. One easy test is to look at your leg length while lying on your back. Lay on a flat surface with your shoes off and have a friend lift both of your feet off the floor (holding the soft area behind your ankles) about 18”.  Keeping the inner ankles together and the legs parallel and in alignment with the spine, see if the ankles touch each other or become misaligned. Although very basic, misalignment at the ankles will usually indicate hip rotation. Under a ¼” difference is probably OK but anything more is significant and indicates imbalance. Pain is not a good gauge for this test as I’ve seen many patients whose ankles more than a 2” difference and were not experiencing any symptoms.

Correction of structural alignment is not usually complicated or time consuming. A complete evaluation and history to determine the cause, direction and degree of the hip rotation and associated muscle imbalance tells us where and how to adjust the pelvis and which muscles need activation. Once the distortion is removed at home exercises will stabilize the alignment and keep the body working the way it should.

The lasting result of these steps is a happier runner that will probably need less pain killers, and is not on “skating on thin ice” with a body that is only one step away from its next injury. So if you have injuries that don’t heal, or feel like you are doing everything right but not getting the results you want, check for one of the signs of muscle imbalance; it could be the answer you’re looking for.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a consultation one Saturday per month at Salt Lake Running Company (Salt Lake store) by appointment. He can be reached at 801-486-1818 or online at www.utahsports andwellness.com

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