Prehab/Rehab for Lower Body Kinetic Chain
By Annika Landis
Enjoy Winter / NTS Factory Team Member
Glutes/Glute Medius - Important for stability, shock absorption, balance, and prevent excessive lateral movement. Weak glutes lead to pain in the IT band, knees, calves, and lower back.
My training year has gotten off to a more conservative start than usual, and many of my ultra running and adventuring goals have taken a backseat to a different priority: injury rehab. After trying to tough my way through some hip pain since last August (don’t do this!), I finally got some imaging done in April and was diagnosed with greater trochanteric bursitis, which is essentially persistent inflammation in the bursae around the joint usually caused by overuse. This past season, I spent far less time in the gym and lost some of the muscular and connective strength that helps to support big training loads. I asked my body to support a certain level of abuse (which included a lot more running), without giving it all the tools it needed to do so effectively. With each stride you take running, you are transmitting anywhere from 3 to 8 times your body weight in force through your joints. That is A LOT and even if you don’t do a lot of running, it's crucial to make sure that your joints are protected in any sport by strengthening everything around them.
Heading into this summer, I knew that if I wanted to pursue my ultra running goals, I would need to be diligent about my rehab. My rehab is a two-step process which consists of (1) reducing/breaking the inflammation cycle and (2) strengthening everything around my hip to minimize further inflammation. In this article I am going to focus on #2 - strengthening - and, whether you are injured or not, fortifying the connective tissues around your joints can go a long way towards keeping your body injury free and ready to take on whatever crazy adventures or training you ask it to do.
Here is an overview of some lower-body pre/rehab that will help keep you held together and structurally sound. I target the following muscle groups consistently, either as part of strength or as activation before a workout: Click each muscle group for more info.
Hip ABductors - Abductors are on the outside of your hips, these stabilize your hips and prevent your knees from caving in.
Hip ADductors - Addductors help bring our legs back to center during each stride, maintain proper alignment, and generate power.
Hip Flexors (psoas & Illiacus) - Important for ‘flexing’ the legs and hip, explosiveness, and controlling leg movement. The Psoas Hip Flexors connect into your lower back and core and are often a source of back pain if they are tight or weak.
Core: Your core is a lot more extensive than most people think and having a strong core prevents against a lot of imbalances. ALL of these exercises require core engagement even if they aren’t primarily a core exercise.
All of these muscle groups make up your lower body kinetic chain - and issues with one can create pain elsewhere. There are two ways you can use these exercises: activation and strengthing.
1. Activation - The purpose of this is to activate and engage the muscles, joints, and connective tissues that you are going to use in your workout. This helps prevent certain muscle groups from overcompensating for weaker or unactivated ones. This dynamic warm up should take about 10-20 minutes and you can do it anywhere from the living room to the trailhead parking lot. Since you are activating, the exercises should be relatively easy - the point is to wake up and get things firing, not to fatigue. Use a lighter band (green or yellow), or none at all, and focus on deliberate and focused movements.
Sample Pre-Workout Activation:
2. Strengthening: The purpose of this is, (you guessed it!) to strengthen your muscles, joints, and connective tissues. I add this as part of my warmup routine for strength, and add exercises into general strength sets. Exercises in your warmup should be more like the activation above in terms of difficulty, and exercises in strength sets should be more difficult. Remember that the goal is always deliberate movements with good form and core engagement, so only increase the difficulty once you have mastered the movement.
And 3x 2-4 of these as a strength exercise
If you are doing this as a stand alone strength routine, choose 4-6 activation and 4-6 strength. If you are combining it into an existing strength plan, add/ substitute 2-4 activation and strength exercises.
This is by no means an exhaustive list (youtube is great for more ideas), but it's a good start and well worth your time to add them into your weekly routine. You can add them into your existing routine however you want, as long as you are deliberable and above all CONSISTENT. Your hips and glutes are incredibly important for stabilization and power application, and keeping them strong will also fend off a host of other ‘injury chain reactions’ (bad back, etc…).
A list of exercises is linked HERE. The majority of them can be used as activation or strengthening, you just adjust the difficulty by adding bands, weights, holds, etc.
The best rehab is pre-hab!