As I discussed in the Multiplanar Strengthening Exercises post: although the overall movement of the body is often straight line, the contributing movements joint by joint are almost always a mixture of movements in all three planes of motion. Therefore muscles controlling these joints and producing movement need to be stretched and kept mobile in all three planes.
If we look at a classic calf stretch where everything is in a straight line, the calf muscles are being stretched with the foot and ankle moving into end of range dorsiflexion, however there isn’t normally much of a stretch into pronation and supination.
Have a look at the video below and see how as we move the front leg across the body and back in a calf stretch position it works the rear foot through passive pronation and supination – thoroughly stretching the overlaying muscles in all three planes of motion.
As a follow on from my previous post about Multiplanar Strengthening Exercises, I also want to mention the importance of keeping an eye on the quality of execution of the exercises.
It’s not uncommon for me to meet a frustrated athlete with, for example, anterior knee pain who has been given rehab exercises by their physiotherapist and has been diligently performing them, with no improvement in symptoms. Usually it’s not because the exercises prescribed are wrong, more-so the fact that the exercises are, through no fault of the athlete, being performed incorrectly.
The problem is that unless you’re an elite performer with full time support, nobody is there to watch over you and give feedback on form and quality as you perform the exercises.
A CLASSIC EXAMPLE: THE SINGLE LEG SQUAT
Most people (especially who have a tendency to underuse their glutes and dominate movements with their quads) will perform a single leg squat in such a way that inhibits the glutes from engaging as they should – due to the lack of motion at the hip throughout the exercise. By focussing on sitting back into the squat and loading through the heel, the glutes will be more inclined to engage.
The contrasts in form can be seen in the two stills below. Note how the knee stays behind (or at most inline with) the toes when squatting correctly. As soon as the motion at the hip is lost, the knee pushes forwards of the toes and takes increased load through the quads.
APPLIED TO ALL EXERCISES
This same principal of making sure you are executing your rehab and strengthening exercises well should be used for all exercises you perform. You don’t want to schedule precious time to get your exercises done and then find that you’ve been effectively wasting your time with poor form.
Just like everything else in training, it’s important to train smart with your rehab and strengthening exercises!
You should know which muscle group each exercise is targeting and should be able to feel that muscle group working. If you’re trying to work your hamstrings for example and only feel the exercise in your back – the chances are you’re doing something wrong!
If in doubt, get a professional to take a look at your form and advise appropriate exercises.
We explore the need for triathletes and runners to incorporate multidirectional strength exercises into their regular program, and show you some great exercises to enjoy the benefits of this type of training.
Triathletes and runners spend most of their time engaged in what are primarily “straight line” activities, particularly running and cycling. Certainly most of the load bearing work that most triathletes and runners complete is uni-directional.
Not only are these movement patterns uni-directional (running in a relatively straight line and cycling), they are also very repetitive, repeating the same movement pattern again and again both in training and in competition with very little variety to our movements.
Those of us who do any strengthening work at all on a regular basis to supplement our running, swimming and cycling (definitely the minority!), often fall into the trap of also only doing straight line exercises such as squats, lunges, step-ups and single leg squats.
“So what? Those straight line movements mirror the demands of our sport…”
“Well yes and no…!”
Remember this important fact:
The body is able to move through three planes of motion at one time. And at any given time it’s moving in all three. Just because (using running as an example) the outcome is a uni-directional “one foot in front of the other” movement, it doesn’t mean there isn’t lots of rotation and lateral motion going on behind the scenes to produce that movement!
Lets look into the anatomy of different types of muscle for a second:
Planes of MotionThe big, powerful, two joint muscles which help to drive us forwards (think hamstrings, rectus femoris, quadratus lumborum etc…) all have their fibres aligned longitudinally, making them very good at producing force into flexion and extension in the sagittal plane, and pretty rubbish at controlling rotation and ab/adduction in the transverse and coronal planes respectively.
On the other hand, the muscles which provide stability as we move (think glutes, obliques and adductors etc…) all generally have fibres which lie at more of an oblique angle, making them very good at controlling rotation and ab/adduction in the transverse and coronal planes respectively… but pretty bad in comparison at producing straight line power on their own.
So what happens when we train predominantly the muscles which work to produce straight line, sagittal plane movements? They become the ones which get worked hardest and develop strongest, leaving the muscles which get loaded more effectively through rotation and lateral movement (yet are responsible for providing stability as we run and cycle) to remain weak and deconditioned.
These days, common underlying causes given by medical professionals when assessing the cause of overuse injuries in sports such as ours are “poor stability” somewhere or “weak glutes”, or another diagnosis linked to the conditioning of these stabilizing muscle groups which thrive on rotational and lateral loading to provide stability.
So logic would dictate that to help remain injury free, become more stable and improve functional strength, we need to train these stability muscles. We can do this highly effectively by adding rotational and lateral strengthening work to our weekly schedules.
Below is a video showing just a few examples of such exercises.
It’s no coincidence that triathletes and runners who have more of an all round sporting background, especially those who play(ed) multidirectional sports involving twisting and turning seem to have more resilient bodies when it comes to training. Perhaps because their all-round, multidirectional, multiplanar strength is more advanced than those who just run.
Try some of the exercises in the video for yourself and see how you get on.
One of the more common running injuries is a calf strain or a tear resulting in calf pain. The biggest of the calf muscles, “Gastrocenemius” to use its correct name, is the largest and most superficial of the muscles in the lower leg and is loaded repetitively and heavily during running sports.
With every stride we take when running, the calf gets loaded, firstly to absorb the shock of our body weight landing, then to help propel us forward into the next stride. Now take into account that for every mile we run we take about 1500 of these strides. Looking at it like this makes it easier to see that if there is a weakness in the calf complex, or a fault elsewhere in the kinetic chain or running technique which leads to more stress going on the area, calf pain through injury is almost inevitable.
The calf is classified as a global mobilizer muscle, meaning that its main anatomical function is to absorb and then create large motions and forces. It is accompanied above and below by stabiliser muscles which are responsible for keeping the joints crossed by the calf stable – so that it can carry out its main function. However, if stability is compromised, particularly at the foot and ankle complex, leading to excessive pronation, the calf will begin to try and take on a stabilising role also – leading to loading it is not positioned well to cope with.
Often a poor warm-up is cited as a reason why athletes suffer calf pain through injury. Most of us appreciate the necessity for a thorough warm-up. Let us consider why in the case of the calf complex particularly, a good warm us is important in avoiding injury: The calf runs down from its medial and lateral attachments above the knee and blends with the achilles tendon – which in turn attaches at the base of the heel. The calf and the achilles tendon act as one dynamic structure during motion. As the calf complex is loaded, a portion of the load is taken by the elastic properties of the achilles tendon, sharing the load with the calf muscles. If the achilles tendon is not warmed up sufficiently, these elastic properties of the achilles tendon will not be displayed and more of the load will have to be taken by the calf.
It is also important to note that as we age, these elastic properties of the tendons in general diminish – thus accounting for the increased occurrence of calf strains in the more senior of our athletic population.
Grades of strain or tear:
Muscular strains are classified according to their severity in terms of how many fibres have been disrupted or ruptured
Grade 1:
This is the least severe of calf injuries. A small number of muscle fibres have been damaged within the muscle. Signs and symptoms of this type of less serious strain may not be noticed until cessation of the activity. Tightness, cramping feelings and slight soreness are common when the muscle is stretched.
Grade 2:
This is sometimes referred to as a partial calf tear. A greater number of muscle fibres have been torn, however the muscle remains largely intact. More immediate localised calf pain is present during activity, especially walking and running. Often the area is sore to touch.
Grade 3:
Total rupture. All the muscle fibres have been torn, losing continuity throughout the muscle. This is a serious injury and highly disabling. The athlete will be unable to walk pain free. Often bruising will appear below the tear site and there may well be a palpable bulge where the calf muscle has recoiled upon itself.
CALF PAIN – TREATMENT AND REHABILITATION:
Treatment of most calf injuries is initially much the same as that of any soft tissue injury. The Rest, Ice, Compression, Elevation (R.I.C.E) principal should be followed. Then a gradual return to exercise undertaken. Sports massage is also good once the initial acute phase has passed. In terms of timescales for rest, a good rule of thumb is 3 weeks for a grade 1 strain and 4-6 weeks for a grade 2 strain. A grade 3 tear will most likely require surgery followed by a 12 week rehabilitation programme.
As with any injury, on the road to recovery, progressive and comprehensive exercise based rehabilitation is key to avoiding recurrence or secondary injuries. These often occur through compensatory movements which may have become habit during the injured period.
As with any injury, the rehabilitation phase is an ideal opportunity to target those areas we all ignore in our weekly training routine. The core muscles and glute muscles are a great place to turn focus to when you are restricted in terms of activity. The stronger these muscles can become, the more likely a successful outcome is to be reached both in terms of injury recovery and subsequent performance.
Particularly after any injury to the leg, the first step in the rehabilitation process is to correct any limp that may remain after the pain has gone. These limps become habitual both in running and in walking and can cause problems in areas such as the lower back.
Specific single-leg exercises are important to build the strength in the injured limb and take away the temptation to use the other leg to bear an uneven portion of the load. These exercises also enable the body to regain its sense of balance which will have been lost on the injured side during the injury period.
Once improvements have been made in single leg strength and balance, low level plyometric exercises may be re-introduced as a precursor to running. Jumping, hopping and skipping are all useful to re-introduce the muscle to the dynamic loading needed for running.
Once successfully progressed through the multidirectional plyometric exercises, running may be re-introduced in short bursts. A sure way to re-injure the muscle is to do too much too soon at this stage. Running is to be approached with a methodical approach in terms of progressing from session to session. Keep a watchful eye on running technique – especially foot position on contact.
Begin with straight line runs with gradual acceleration and deceleration. Then slowly introduce changes of direction and more aggressive changes of pace.
CALF PAIN – REHABILITATION EXERCISES:
Single Leg Squat
Balancing on one leg, flex at the hip, knee and the ankle performing a mini squat keeping the knee aligned with the first two toes, then return to the standing position. Repeat this maintaining alignment of the knee.
Calf Raise
Start standing with the heels hanging off a step, with your bodyweight supported on the balls of the feet. Slowly allow the heels to drop towards the ground, coming below the height of the toes, then rise up using the calves so that the heels come higher than the toes.
Calf Stretches
With one foot far in front of the other, and hands pushing on the wall, keep the rear leg straight and flex the front knee. Pushing the rear heel into the ground, a stretch should be felt in the calf.
Wobble Cushion Balance
Balancing in a single leg stance on any unstable surface. Begin with a reasonably stable surface, and progress by increasing time or decreasing stability.
Jumps
Staying ‘light’ and landing on the forefoot, jumps are a great way of re-introducing the calf complex to more dynamic loading. Begin with a set of 10 jumps on the spot. Then progress to doing as many jumps between one spot and another for 20 seconds. Further progression entails adding multidirectional jumps in all planes of motion.
Hops
Following the same methodology as that used when progressing through the jumps program: perform these dynamic motions as hops – preventing the body from compensating through using the uninvolved leg.
Some of our athletes have asked us to put together an example 12 week running program for those who are coming back from injury.
This simple-to-follow program guides you through 3 months of gradual progression of running volume to safely build up running time as the previously injured tissues get stronger again.
CHANGING YOUR RUNNING STYLE
Use the program below to provide structure for an important 3 month transition phase as your body adapts to a new running style.
This is particularly important to help runners avoid the common and painful ‘too much, too soon’ trap – when changing from a heel striking to midfoot or forefoot striking gait pattern!
IMPORTANT
All running to be completed at a easy pace.
No speed work until you complete this ‘return to running’ phase!
Don’t run on consecutive days – give your body time to recover.
EXAMPLE PROGRAM
Week 1: 3 sessions of: (Run 1min : Walk 1min) x 10
Week 2: 3 sessions of: (Run 1min 30sec : Walk 30sec) x 8
Week 3: 3 sessions of: (Run 2min : Walk 30sec) x 8
Week 4: 3 sessions of: (Run 3min : Walk 1min) x 8
Week 5: 3 sessions of: (Run 4min : Walk 1min) x 8
Week 6: 3 sessions of: (Run 5min : Walk 1min) x 6
Week 7: 3 sessions of: (Run 10min : Walk 1min) x 3
Week 8: 3 sessions of: (Run 15min : Walk 1min) x 2
It’s important to make sure you focus on technique throughout and develop the ability to maintain good form consistently as the run durations increase.
Also, be sure to supplement this running work with appropriate strengthening exercises.
During each run, stop at the first sign of any discomfort.
This program is intended as reference guides, and may not be appropriate for everyone. Kinetic Revolution accepts no responsibility for any injury of loss which may occur through the following of such programs.
One of the most common experiences for people trying to change their running form to a forefoot or midfoot strike is to suffer from tightness and soreness in the calf and achilles region.
Usually this is as a consequence of trying to do too much running with this new technique too soon, having not allowed muscular adaptation to the demands of the loading pattern.
This adaptation takes time. It is particularly the calf/achilles complex which experiences greater loading with forefoot/midfoot running in comparison to it’s loading during a heel-striking pattern.
The most effective method of prevention when it comes to this tightness is to make sure that you start with only small amounts running volume, increasing progressively over time.
There are however a number of drills and exercises we use, enabling runners to condition and strengthen their legs to the demands of this type of foot strike.
Take a look at our Online Running Technique Programme which provides detailed session plans and video instructions for those who are looking to make the transition to a forefoot or midfoot running style.
One such drill is the “Hop and Stop” drill:
