Regions & Muscle Groups Runners Should Address

Intrinsic foot muscles

• support the structure of the foot

• prevent excessive forefoot abduction with midfoot pronation and hallux valgus.

Common injuries resulting from deficiency: plantar fasciitis, tibialis posterior tendinopathy, medial tibial stress syndrome (“shin splint”), medial knee pain/MCL strain, hallux valgus deformity (bunion).

Peroneals/fibularii

These provide ankle stability and proprioception. Generate ankle eversion and assist in plantar flexion to help maintain neutral alignment during plantarflexion.

Common Injuries resulting from deficiency: inversion ankle sprains

Ankle Dorsiflexion (DF) ROM

• reduce stress on the entire kinetic chain - foot, knee, hip, back.

• Adequate DF allows you to better utilize the elastic properties of the plantarflexors (gastroc/sol) while running.

Compensations for lack of DF- forefoot abduction, hallux valgus, excessive pronation, tibial internal rotation (IR) and knee valgus, femoral internal rotation (IR) and adduction, increased hip flexion, increased lumbar flexion

Common injuries resulting from deficiency: plantar fasciitis, hallux valgus (bunions), Achilles tendinopathies, tibialis posterior tendinopathy, medial tibial stress syndrome (“shin splints”), medial knee pain/MCL strain, Patellar tendinopathies (runner’s/jumper’s knee), patellofemoral pain syndrome, chondromalacia patella, femoroacetabular impingement, lumbar pain/dysfunction

Eccentric Hamstring Strength/Control

Hamstrings (semitendinosus, semimembranosus, biceps femoris) help control knee flexion/extension during swing phase and assist in hip extension during terminal swing phase of running.

Common injuries resulting from deficiency: hamstring strains, “knee pain” from rotational and shearing stresses, proximal gastroc strains, Lumbar pain/dysfunction

Obliques, TA, Multifidi, Pelvic floor, DIAPHRAGM

These muscles create a rigid foundation (core) from which the legs can propel and the arms can swing. Additionally, when this is functioning properly, it will enhance respiratory efficiency (ability to bring in good O2 and get rid of CO2). Lack of core control leads to breakdown in bilateral upper and lower extremity kinetic chains and poor respiratory patterns.

Common injuries resulting from deficiency: hip, low back, and knee pain/dysfunction and literally anything mentioned prior to this or after this plus pelvic floor dysfunction.

Thoracic rotation

Important for proper trunk dissociation without stressing lumbar spine and SI joint, Pelvic/protraction/retraction with contralateral arm swing. Lack of adequate thoracic rotation often results in excessive rotational movements/moments at the shoulders, lumbar spine, Pelvis/SI joint, Hips and can extend through the remaining kinetic chain.

Common injuries resulting from deficiency: Upper trap/shoulder pain, cervical pain, low back pain, SI joint dysfunction, femoroacetabular impingement, knee pain (torsional stress)

Mid/low Trap, Serratus Anterior

create adequate control and stability of the scapula on the thorax to allow proper arm swing mechanics without excessive frontal or transverse plane movement.

Common injuries resulting from deficiency: neck/upper trap/shoulder pain with running.

PSOAS/Iliacus/TFL/Rectus femoris extensibility (hip Extension ROM)

These muscles work heavily as hip flexors during running. Lack of extensibility (ability to relax and lengthen) results in excessive anterior tilting of the pelvis in increased lumbar lordosis. This position often leads to FAI (commonly presents as groin pain), facet joint compression in lumbar spine, and faulty position/alignment of the SI joint.

Common injuries resulting from deficiency: Low back pain, “sciatica”, SI joint dysfunction/pain, Pelvic floor dysfunction, femoroacetabular impingement (groin pain), recurrent hamstring strains (inhibited gluts).

Hip abductors (glut min/med-anterior/posterior fibers)

• maintain neutral pelvis in single leg stance. They prevent acetabulum (the socket) on head of femur (the ball) Adduction and IR (trendelenburg), femoral IR, knee valgus, tibial IR, excess pronation, hallux valgus, forefoot abduction.

Common injuries resulting from deficiency: trochanteric bursitis, glut med/min tendinopathies, patellar tendinopathies, chondromalacia patella, Patellofemoral pain syndrome (“runner’s/jumper's knee”), SI joint dysfunction, low back pain, “sciatica,” piriformis syndrome

Glut Max ER fibers and Deep 6 external rotators (ER) of the hip (similar to rotator cuff in shoulder) quadratus femoris, superior and inferior gemelli, piriformis, obturator internus and externus

These muscles maintain proper position of the SI joint and the pelvis on the femur and the femur on the tibia (knee alignment). Lack of hip ER control results in pelvis on femur adduction and IR or femoral IR, improper tracking of the patella (PFPS/chondromalacia patella), knee valgus, tibial IR, midfoot pronation.

Common injuries resulting from deficiency: tibialis posterior tendinopathy, medial tibial stress syndrome (“shin splints”), medial knee pain/MCL strain, femoroacetabular impingement (groin pain), chondromalacia patella, patellofemoral pain syndrome (runner's/jumper’s knee), “sciatica”, piriformis syndrome.