Stability for Runners – Part 3: Fixing stability issues
By Peter Colagiuri
Identifying the deficit in the stability system is only part of the equation; the bigger challenge lies in learning how to fix the problem. The seemingly obvious fix, strength exercises, often fail as weakness is one of the least common causes of stability issues. So, what’s the plan?
If the cause is joint stiffness, the fix is tricky. Stretches don’t improve joint range, so don’t bother. If the joint stiffness is reasonably fresh, you can use specific forms of running (such as hills) to get it going or you may need to call on your local health professional to work their magic. If the stiffness has been there for more than one year, chances are you won’t improve it and you’ll definitely need to speak to your running-specific health professional about ways to compensate for it (might be altered technique, alternative strength exercises or devices such as orthotics).
If the issue is muscle control, you simply need to improve your coordination and technique. Easy, right? You’ll need exercises that mimic running while encouraging the right muscles to work and the compensatory muscles to relax. You can see some examples here but they’re very specific to your problem. It’s not just where you feel it burning or how hard the exercise is, you’ll need an exercise that’s challenging but not impossible and doesn’t encourage more compensations. If you’re not sure, one trip to your running-specific physio/chiro should do it.
For primary strength issues, it’s not just about making the muscle work hard. It’s about making it work hard at the exact length and function as it performs during running. That’s why clams are the most ridiculous exercise known to humankind and planks don’t work for runners. Again, you can see some examples here but it’ll need to match your situation so choose carefully and don’t just copy a friend.
There are temporary fixes of stability problems related to endurance and strength including supportive shoes, devices (such as orthotics) and taping. These “helpers” can minimise the demands placed on the stability system while the deficit improves and have been shown to delay fatigue of the stabilising muscles. It’s why runners often switch to more supportive shoes for longer runs. But they’ll only help if the right muscles are fatiguing early; if the wrong muscles are working to stabilise the leg, extra support won’t change the muscle patterns and the problem will persist.
On the flip side, there are various aspects of footwear that can compromise your stability. Old shoes that no longer provide a consistent surface underfoot, unsuitable shoes that are too rigid/not supportive enough/just the wrong fit and shoes designed to reduce support, such as minimalist footwear, can all create an environment that increases the stability challenge and can worsen a stability deficit.
Designing stability exercises
Stability exercises are the best way to address most causes of stability issues but they’re also very poorly understood. All the usual suspects, clams, planks, sit-ups, crunches, are all examples of commonly used exercises that don’t target the stability system and have very little value for runners. In short, don’t waste your time. Exercises need to target the right muscles, using running-like movement patterns, in the same positions as running. We don’t lay down when we run, so your exercise shouldn’t be done on the floor. We don’t hold a rigid position, so no plank-type holds.
Think about using simple movements, emphasising control and technique, and make it unstable to challenge the stability system. For example, take a simple walking lunge and add a weight on one side only. Work on it until you are no longer able to maintain form and technique, not until your muscles burn and quiver. In the example of the walking lunge, you could hold the weight out to the side.
As you improve, think of ways of making it more challenging while keeping it in the context of running. From a walking lunge, increase instability by shifting to a single leg exercise. Once that exercise is no longer challenging, you could add speed to dynamic stability by trying a hop and balance exercise.
Each successive exercise is mimicking a more challenging running situation. Eventually running itself can sufficiently challenge the system to maintain stability by including some stability drills, trail running and/or technique practice.
Peter Colagiuri is a Sports Physiotherapist, specialising in running injuries. He practices in Miranda and Manly in addition to researching at the University of Sydney. For more information see bioathletic.com.au, firstname.lastname@example.org or book an appointment (02) 9977 1580.