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Correcting muscular imbalances to improve running economy.

Many runners believe injuries are primarily caused from overuse or poor stretching techniques. It is true that runners who generally run more than 20 miles per week are at increased risk for running-related injuries.

However, many injuries can also be attributed to muscular imbalances in the lower and upper extremities. Without correcting these imbalances, increased strain is placed on the affected musculature and joints. As a result, running is less efficient than when the body is in proper alignment.

Upper Cross Syndrome

In the upper extremity, many desk-bound, sedentary workers are afflicted with a condition known as upper cross syndrome. In this condition, there is a muscular imbalance between opposing muscle groups in the neck, upper back, shoulder, and chest. That is, some muscles become chronically tight while the opposing muscles become lengthened and weak. These imbalances are facilitated by poor postural habits and/or improper stretching and strength training, which can lead not only to poor running economy but to low back pain as well.

In upper cross syndrome, the tight muscles usually are the upper trapezius (located between shoulder and neck), neck extensors, sternocleidomastoid (large muscle located in front of the neck), pectoralis major and levator scapulae (running from neck to shoulder blade). The lengthened and weak muscles are the rhomboids, deep neck flexors, middle and lower trapeziuses, and the serratus anterior. Essentially, the rhomboids, trapezius, and lower part of the serratus anterior are responsible for bringing the shoulder blades together and for down-ward rotation of the shoulder blade (the movement that occurs when initiating a pull-up).

The end result of an upper cross syndrome is a forward head position, rounded shoulders, and rounded thoracic spine. The forward head position will cause the back extensors to work harder in order to counteract the displacement of the center of gravity. This increased strain can result in low back pain and decreased running performance.

Lower Cross Syndrome

With lower cross syndrome, there is also an imbalance between tight and weakened muscles. In this syndrome, the muscles that are tight are the hip flexors and erector spinae; the weak muscles are the abdominals, glures, and hamstrings. These muscles control the position of the pelvis.

With the hip flexors and erector spinae tight, the pelvis is tilted forward, thus producing excessive curvature in the lower spine as well as increased pressure on the facet joints of the spine. The excessive pelvic tilt, coupled with weak glutes and hamstrings, can definitely cause low back pain and reduce running efficiency.

Correcting Upper Cross Syndrome

So how do you fix these conditions? Basically, you must strengthen the weak muscles and stretch the tight muscles. Most people do not identify which muscles are tight or weak and end up stretching everything or nothing at all. In both cases, the syndromes are facilitated, not corrected.

The first thing to do is to identify if you have upper or lower cross syndrome. If you have low back pain and your ears do not line up over your shoulders when standing straight, there is a strong possibility that you have upper cross syndrome. Knowing this, you must strengthen your scapular adductors and stretch your chest.

Throughout the day--at least every half hour--sit straight up in your chair or lie face down on the floor. While looking straight ahead, retract your chin towards your neck. At the same time, rotate your hands outward so that your thumbs point behind you and squeeze your shoulder blades together. Hold for 10 seconds, then rest for 5. Repeat 10 times. Figures 1 and 2 on page 25 show proper scapular adduction of shoulder blades and proper head position. Figure 3 shows improper extension of the head.

Correcting Lower Cross Syndrome

With lower cross syndrome, the hamstrings, glutes, and abdominals must be strengthened and the hip flexors stretched. To strengthen your glutes and hamstrings, do hip bridges by lying on your back with knees bent. From this position, press your feet on the floor and lift your glutes and lower back off the floor. Your upper back and head will still be on the floor. Slowly lower your glutes to the floor and repeat 40 times.

Figures 4 and 5 show the positioning for this exercise.

To increase the difficulty, bend only one knee and extend the other leg. Repeat the lift 20 times for each leg.

To stretch the hip flexors, lie on your side with your opposite leg bent. Grab your ankle and pull your thigh backward while keeping the leg bent. Hold for 20 seconds and repeat on the other side.

Strengthening abdominals is a lot more complicated than most people realize and entails more than doing sit-ups or crunches. A sports health professional can show you the proper way to recruit the abdominals when performing core strengthening exercises.

No Pain--Your Gain

Correcting these syndromes is vitally important in improving running performance and reducing the risk of injury. The lengthened and tight muscles are not functioning at optimal length, which reduces the force of muscular contraction and puts the muscles at greater risk of being strained. In addition, compensatory musculoskeletal and neuromuscular mechanisms must occur to counteract the altered body mechanics. As a result, ground reaction forces are not properly dissipated, thus leading to injury.

Conversely, if these syndromes are properly addressed, running economy is improved (since the muscles are working at their optimal length), and the chance of suffering from low back pain in the workplace is reduced.

(For personnel stationed at the Pentagon, the Fit To Win Office at the DiLorenzo TRICARE Health Clinic can help you identify and develop exercise programs to correct these syndromes. The staff can be reached at (703) 692-8898.)

David J. Holes received a dual B.S. degree in physiology and kinesiology from the University of California and an M.A. degree in exercise physiology from the College of St. Scholastica in Duluth, Minnesota, He holds personal training certifications from ACSM, NSCA, ACE, and the American Academy of Health Fitness and Rehabilitation Professionals.
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Author:Holes, David J.
Publication:Armed Forces Comptroller
Geographic Code:1USA
Date:Jan 1, 2003
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