Jonathan Messner, MS, CSCS

There has been much speculation as to why distance runners incur so many injuries. The most common opinion has been the “pounding” the body takes every time it hits the ground (Daniels, Martin). However, this article will take a closer look, and a much less popular look at the reasons why distance runners get hurt as much as they do.

Movement Patterns
The demands of sport are extremely complex and they impact the body and its system as a whole, singular unit. Everything within the system is reliant and dependent on everything else within that system.
Every single movement, from one breath, to one phase of gait in a run, is a movement pattern. It is our brain telling our muscles when to fire to perform movement. These patterns are “programmed” into our brains and are natural to survival much the same as eating and sleeping. Efficient movement occurs when the right muscles fire at the right time. However, it is very difficult to quantify the right muscles firing at the right time during complex movement and also, not well documented. However, many leading authorities in the strength and conditioning industry allude to common patterns in strength training (Boyle, Chek, Cook). Strength training for runners should focus on improving these movement patterns of this very complex system.

Needs of a Runner
The physiological characteristics that dictate distance-running performance are VO2 max, lactate threshold, top end speed, and running economy. The only characteristic that is directly affected by strength training is running economy (Johnson). Running economy is defined as the energy demand for a given velocity of submaximal running (Saunders). Running economy is based on a runner’s gait, (Tseh) which is essentially one movement pattern after another.
Running economy dictates the chances a runner has for getting injured. The better a runner’s economy, the less chance they have for incurring an overuse injury. By preventing a running injury we are therefore improving the performance of the athlete.
When an overuse injury occurs, it occurs because of a less than ideal movement pattern. This less than ideal motion is repeated thousands upon thousands of times. The musculoskeletal system continually incurs microtrauma and the body develops a movement impairment syndrome. “The term regional emphasizes the lack of an underlying systemic disease, supporting the belief that local mechanical trauma is the causative agent. Other common terms used to describe localized pain are musculoskeletal disorders, musculoskeletal dysfunction, myofascial syndromes, overuse syndromes, cumulative trauma, and repetitive strain injuries… These syndromes are defined as localized painful conditions arising from irritation of myofascial, perpetuation, or articular tissues. Their origin and perpetuation are the result of mechanical trauma, most often, microtrauma. Microtrauma is often ascribed to overuse, which is the repeated use or an excessive load that causes stress that exceeds the tissue’s tolerance to withstand injury.” (Sahrmann)

Exercise Prescription
Each movement and change of movement affects infinite micro systems of the human body; therefore making the body stronger can be a very overwhelming undertaking. The fact that running is a series of complex movement pattern makes this task even more difficult. Trying to change someone’s running form for the better while they are running could potentially exasperate any dormant injuries.
The goal of any strengthening program should be to improve the athlete’s movement patterns. Efficient movement occurs when the hips have sufficient mobility and the lumbar spine has sufficient stability (Fairies). Furthermore, the gait cycle is comprised of both knee-dominant and hip-dominant movements in very short ranges of motion which, over-time, put athletes at risks for injuries. Therefore, knee-dominant and hip-dominant exercise must be loaded in a full range of motion. If we accomplish these goals, we put the athletes in a much better position to remain injury free.

Hip Extension
A common mistake during hip extension is spinal extension. When spinal extension is trained, lumbar spine issues may arise. Hip extension must be taught with a stable midsection.
- Quadruped Hip Extension
o Begin in four-point stance
o Place one knee slight elevated over the other knee
o Maintain a 90 degree bend in both knees the whole time
o Extend the hip without extending the lumbar spine
o Goal is to increase the ROM of the hip
o Goal is to “feel” your glutes fire
o Perform 3 sets of 5 reps on each side, hold each contraction for 5 seconds

- Bilateral Bridge
o Begin in supine with knees bent at right angles
o Place a towel-roll in-between your thighs
o Place your thumbs on the sides of your buttocks to cue gluteul contraction
o Squeeze your glutes while you lift your hips as high as you can
o Goal is to “feel” your glutes fire
o Perform 3 sets of 5 reps, hold each contraction for 5 seconds

The squatting pattern is a derivative of all locomotion. Before any of us walked or run, we crawled. Our transition from crawling to walking was squatting. We squat all day long when we stand-up and when we sit. Because of compensatory motions, however, we may be using the wrong muscles to perform these tasks (Sahrman). Many of us are in fact, quadriceps or hamstring dominant (Youdas). That is, our quadricepses are too strong and hips (glutes) are too weak. In order to maintain strength in the squatting patterns, and subsequently strong knees and a strong back, we must have the proper ratio of glute to quadriceps strength.
- Bilateral Squat
o Place hands behind the head, keep elbows back
o Sit back with your hips and place all your weight in your heels
o Slowly lower yourself down to the box
o When you get to the point where you cannot maintain a slow eccentric descent, you have reached functional end range of motion in the squat
o Perform 3 sets of 5 to 10 reps

The bending pattern is where most clients and athletes with back pain are deficient (Sahrman). They initiate a bending action with their torso and not their hips. Subsequent bending about the spine can lead to disk degeneration or herniation or both.
- Unilateral Bend
o Stand on one leg with a slight bend in your leg
o Bend forward by pushing your hips back
o Squeeze the glute of the elevated leg and keep it straight with the rest of your body
o Do not forward flex (i.e. bend from your waist)… make sure you are bending from your hips… depending on the individual, hip range of motion can vary greatly
o End range of motion is when you feel a stretch in your posterior chain (glutes, hamstrings, or calves)
o Perform 3 sets of 5 to 10 reps

1. Christou, M., I. Smilios, K. Sotiropoulos, K. Volaklis, T. Pilianidis, and S.P. Tokmakidis. Effects of resistance training on the physical capacities of adolescent soccer players. Journal of Strength and Conditioning Research. 20:783-791, 2006.
2. Boyle, M. Functional Training for Sport. Champagne, IL: Human Kinetics, 2004.
3. Chek, P. Movement that Matters. San Diego, CA: C.H.E.K. Institute, 19-20, 2000.
4. Cook, G. Athletic Body in Balance. Champagne, IL: Human Kinetics, 3-5, 11, 29, 2003.
5. Daniels, J. Daniel’s Running Formula. Champaign, IL: Human Kinetics, 80, 1998.
6. Deschenes, M.R., C.M. Maresh, and W.J Kraemer. The neuromuscular junction: Function, and its role in excitation of muscle. Journal of Strength and Conditioning Research. 8:103-109, 1994.
7. Faries, M.D. and M. Greenwood. Core training: Stabilizing the confusion. Strength and Conditioning Journal. 29: 10-25, 2007.
8. Fischer, D.V. Neuromuscular Training to Prevent Anterior Cruciate Ligament Injury in the Female Athlete. Strength and Conditioning Journal. 28: 44-54, 2006.
9. Fry, C.W., W.J. Kraemer, C.A. Weseman, B.P. Conroy, S.E. Gordon, J.R. Hoffman, and C.M. Maresh. The effects on an off-season strength and conditioning program on starters and non-starters in women’s intercollegiate volleyball. Journal of Strength and Conditioning Research. 5:174-178, 1991.
10. Hasegawa, H., J. Dziados, R.U. Newton, A.C. Fry, W.J. Kraemer, and K. Hakkinen. Periodized training programs for athletes. In: Strength Training for Sport. W.J. Kraemer and K. Hakkinen, eds. Oxford: Blackwell Science, 2002. pp. 69-134.
11. Johnson, R.E., T.J. Quinn, R. Kertzer, and N.B. Vroman. Strength training in female distance runners: Impact on running economy. Journal of Strength and Conditioning Research. 11:224-229, 1997.
12. Martin, D.E. and P.N. Coe. Better Training for Distance Runners. Champaign, IL: Human Kinetics, 9, 1997.
13. Myer, G.D., K.R. Ford, J.P. Palumbo, and T.E Hewett. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. Journal of Strength and Conditioning Research. 19:51-60, 2005.
14. Sahrmann, S.A. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis, MO: Mosby, 5, 2002.
15. Saunders, P.U., D.B. Pyne, R.D. Teleford, and J.A. Hawley. Factors affecting running economy in trained distance runners. Sports Medicine. 34:465-485, 2004.
16. Tseh, W., J.L Caputo, and D.W. Morgan. Influence of Gait Manipulation on Running Economy in Female Distance Runners. Journal of Sports Science and Medicine. 7, 91-95, 2008.
17. Youdas, J.W., J.H. Hollman, J.R. Hitchcock, G.J. Hoyme, and J.J. Johnsen. Comparison of hamstring and quadriceps femoris electromyographic activity between men and women during a single-limb squat on both a stable and labile surface. The Journal of Strength and Conditioning Research. 21:105-111, 2007.