“If You Can’t Do This Exercise, You Will Get Hurt:” Hip Stability And Alignment For Trail Runners
Hello, my name is Joe Uhan, and I’m a leaner. I’ve been one for years: living in leaner denial. It’s wreaked havoc on my running life for years: myriad aches and pains, injuries, and inefficiencies derailing training and racing. All the quick fixes–taping, inserts, and simply leaning the other way–were mere BAND-AIDs to the bigger issue. I was powerless.
I had to get stronger.
A leaner is a runner whose trunk deviates to one side while running. For those of us out there, leaners almost always lean consistently to the same side: not out of habit or simple trunk weakness, but as the end result of a more complex, systemic compensation.
Quite simply, if the body perceives weakness or instability–usually at the foot, ankle or knee–then it will shift the pelvis to that side to aid in stabilization. With the pelvis shifted to the weak side, this creates a leaning effect with the trunk. See to the right an example of an Uncompensated Trendelenburg pattern, where the pelvis shifts right to help stabilize a weak, unstable right leg. This causes the trunk to compensate left, creating a ‘leaner.’
The obvious strategy to correct a leaner is to, well, just lean the other way. But without addressing the root weakness, a counter-lean is merely a temporary and unsustainable fix. To be balanced, the body must be stable. The solution, then, is to develop maximum trunk, hip, and leg stability from the ground up.
Staying Upright: The Role of the Brain in Creating Compensatory Stride Imbalances
A year ago, we outlined the importance of a strong foot–“Elite Feet”–as the foundation of a stable landing and push-off while running, and how a properly aligned leg automatically activates hip muscles for maximum power and efficiency.
If a strong stride starts at the foot, it ends at the trunk and pelvis. Hip and core stability is crucial in maintaining the whole leg alignment, and how the body stacks on top of it. Quite simply, the object of running is to be able to instantaneously balance the entire weight of the body on a single leg, for a split second… then repeat that three times per second for however long you run!
Given that, you can imagine the strength and stability it takes to align all those moving parts in a straight line, and then keep it that way, over rock, root, and ridgeline.
You gotta’ be strong.
But herein lies the issue:
The brain (the Central Governor) only cares about itself. In order to keep you from falling (and bouncing the Governor against an unforgiving rock), the brain will paper-over any instability with compensation: weak foot or knee? It will simply shift the pelvis over and voila! Stability.
While this compensation keeps you upright, it is by no means efficient. When the brain compensates, alignment and symmetry is lost:
- The yin-yang balance of rearward push-off and forward hip drive is disrupted. A compromised push-off creates over-stride stress on the landing leg.
- A shifted trunk adds excessive landing stress to one side (even in the absence of a visible ‘leaner’).
These are the two primary driving forces in running injuries!
It’s All in the Hips: Trunk and Hip Stability are Crucial for Balanced Alignment
One of the premiere researchers in running injury is Chris Powers, DPT. His Movement Performance Institute is a leader in lower-extremity biomechanics and running-injury research. Powers identifies the problem of hip weakness as an issue of redundancy. As he puts it: “The hip is a redundant muscular system: it is easy to compensate!” In other words, evolution has made it so we can compensate many ways to remain upright, yet there is only one true efficient state.
His research has helped identify not only the importance of hip strength in aligning and controlling the leg, but also the vital importance of a strong core. As he puts it, “How can the hip be strong without a solid base?”
Based on that notion, his approach to treating injured runners involves the following progression:
- Isolated core stability and hip activation in non-weightbearing
- Progressive functional strengthening of the hips on a stable trunk: floor to standing
- Running-specific “movement re-education” exercises
Like ultramarathon training, you first gather the necessary components of stability and strength, then patiently assemble in order:
- Trunk stability
- Activated hip (gluteal) and lower-leg muscles
- Stable alignment: trunk on pelvis, pelvis on leg
Putting it all together–and keeping it together–is the key to efficiency, balance, and speed.
The Stacked Line-Up: The Ice Skater Exercise
This one exercise, which I call The Ice Skater (an homage to my Minnesota roots) represents the proper running alignment:
- A neutral trunk centered over one foot
- Level pelvis
- A knee centered (outwardly) over a third toe
- A strong, neutral foot
As described in the video, this exercise can be performed in slow repetitions, or as a prolonged endurance hold (of up to a minute).
This is a tough exercise. Because one must simultaneously control the foot, ankle, knee, hip, pelvis and trunk, many runners–myself included–initially do not have the strength to perform it well. Foundational strength must first be developed. I recommend these trio of exercises, also derived from Dr. Powers’s work:
- Hip Abduction
For such a simple exercise, it is extremely easy to compensate. The key to this exercise is a straight ear-to-ankle alignment.
- Clamshell Side Plank
This exercise develops trunk stability, strong shoulder blades (an oft-overlooked component of running mechanics), hip stability (on the ground side), and active mobility through the clamshell motion.
- All Fours Fire Hydrant
While this exercise looks easy, controlling the trunk, pelvis, and shoulder blade–maintaining all in neutral–adds a layer of complexity and running specificity to this exercise. The goal is to isolate motion at the hip–the same goal as running.
- Arching the spine
- Shifting the pelvis (usually shifting away from the side of motion)
- Opening (rotating) at the pelvis
Open the leg (‘watering the fire hydrant’) only as wide as you can without moving anything else. Perform slow sets of 10 per side. End goal: one minute sustained hold each leg.
Once all three of these preparatory exercises can be completed with good technique, you have what it takes to successfully tackle The Ice Skater.
Alignment Equals Performance: Strong Hips and Core Powers Fast Running
As my patients muddle through hours of tedious exercise, bound by therapy tubing, I console them with one statement: you will be faster.
Alignment isn’t simply about pain relief and injury prevention. Like a perfectly wired electrical circuit, neutral alignment creates automatic hip power: when everything is stacked, the hips–nearly indefatigable–ignite effortlessly and relentlessly. Out of alignment, the body compensates with weaker muscles–pushing and bouncing with quads and calves that have a limited shelf-life before succumbing to cramps and thrashing fatigue.
Efficiency is everything. Do more with less, and do it better. Investing in your stability system will get you more speed out of less miles, and keep you running farther and longer!
Call for Comments (from Meghan)
- Are you a ‘leaner?’ Do you notice your body compensating toward one side or the other? Have you ever noticed this in race or running photos of yourself?
- Can you do the ‘Ice Skater Exercise?’