what if I told you that the likely cause of Scott's knee pain is also the source of a load of wasted effort while he runs and given that his goal is to qualify for the Boston Marathon this is something he's going to want to fix in fact Scott is a subscriber here on the channel and he submitted these clips through the link which you'll find down in the description of this video if you want to go ahead and do the same now I want to spend a little bit of time here actually assessing Scott's running
form giving a little bit of feedback because I know that this is going to help a lot of people whether you've got knee pain or not I want to talk as much about the wasted effort part of this as talking about knee pain but Scott is struggling with a little bit of left-sided knee pain and we'll get into that in a little bit but there's a big part of the way in which he runs which means a lot of the effort that he's actually putting down while he's running isn't helping him move forwards but we'll
we'll like I said we'll we'll get to that let's quickly dial back to this earlier view okay this view where we're looking side on from a running form perspective there's a lot the Scots doing well okay we talk about foot strike a lot we talk about stride length a lot and over striding and I want to reiterate that although we're talking about a runner who's struggled and struggling with knee pain fact he struggled with knee pain on both sides he actually manages to land this foot close to underneath the flexing knee he does does a
good job of what we usually look for see we can see as this foot comes down and lands rear foot first we're Landing so the knee and the ankle are in alignment okay this is exactly what I like to see regardless of the type of foot strike we're talking about center of the knee center of the ankle one stacked above the other okay that's a good sign clear that off let's look at the next side and here again as the foot comes to Flat it comes you can see that initial contacts here we come just
through loading response the beginning of loading response which means the foot's beginning to take a little bit of load and again we can see knee right over the top of ankles so not over striding which is fantastic but I'll tell you where Scott's struggling a little bit in terms of his stride pattern it's actually the other end of his stride it's the back end of his stride What's happen happening as his foot leaves the ground and we get to terminal STS or toe off here what I want to see at this point as this foot
leaves the ground it's this nice flowing extension coming from the hip so I want to see that this leg is driving back nice and straight behind him as straight as is possible in fact what we see here however is that there's at this point where the toes actually to lead the ground we assume his Far Side hip is somewhere around there down to his knee there and then we your knee to ankle we can see that there's actually quite a significant amount of knee flexion still okay so we're not working with this fully extended knee
we're not getting the triple extension that we so often talk about so we're looking to see extension at the hip extension at the knee and plans flection at the ankle to get a good strong push off that extends Beyond running that's just good kind of a letic movement patterning instead in this position where the foot is um sorry the the knee is still somewhat flexed it's indicating that he's not getting a huge amount of hip extension going on and therefore a lot of that extra propulsion is going to need to come from carves and pushing
off through the ankle that's not something I'm super worried about because he's not experiencing any lower leg issues for me what's more important is the way in which as he's lacking a degree of hip extension here it's telling me that he's probably not using his glutes as well as he should be so the question of course in my mind is you know if I was assessing him face to face I'd want to see if those hip flexors were relatively tight okay if we're talking fairly tight hip flexors it's going to create a bit of a
challenge in terms of getting as much hip extension as we'd want to see but also on a neuromuscular level it's going to potentially start inhibiting those all important glutes we want to see those glutes working but if we're tight through those hip flexors then it's going to make it very hard to actually get the most out of these glute muscles so what I'd want to look at is getting him into a program of lots of hip mobility work regular hip flexor stretching work as well as glute strengthen exercises I'm sure his physical therapist has already
given him but knowing that his glutes are most likely inhibited that's what's going to start to get me thinking about all right what's happening from a a rear on perspective because this is where we're losing a load of effort we wasting a load of effort on the right side when he's stand when he's standing on the right landing and loading on the right hand side we look at the waistband Scott has thankfully tucked his waistband in tucks his T-shirt into his waistband for this shot we can see that as he lands and loads a little
bit of a hip drop bearing in mind this is the side that he has had knee pain is currently not a problem in terms of the knee see at this point through to this point we can see that shift downwards I'll play that for you again one one more second but we start roughly there and the waistband ends up dropping down roughly there so we're talking what's at 5 or 6° so you can hopefully see from there through to there the shift now there's a muscle called glute me glutitis medius on the outside of the
hip here which is responsible particularly in this instance for creating a nice level controlled pelvis when glute made isn't ping down on this side of the pelvis to create this level when we're in this single leg stance we see the other side drops down now let's have a look on the affected side the symptomatic side so as we come through play a few more frames we can see gain a fairly big shift I would argue this is more pronounced than the other side and if we play it through at a little bit more pace you'll
be able to see what I'm talking about I would argue that as we're Landing a loading on the left that shift is just that little bit more pronounced now glue me in particular is responsible like we say for creating stability around the pelvis also has an important role to play in terms of abducting the femur abducting the thigh so keeping the thigh away from this position where it drives in towards the midline and the knes become this kind of Knocked knee knee position we're not seeing this kind of knock knee position from Scott we're not
seeing this drift inwards of the knees okay but that's not to say that there's not more stress and strain going through tissues like the ilot tibial band The ITB running down the outside of the leg which could be affecting the way in which the patella femal joint or particularly the the patella sits on the Patel femoral joint um the alignment at the knee there which could start to cause a bit of pain as we start throwing a bit of mileage at that so what I want to see is an approach where we're focusing on lots
of lateral stability exercises lots of exercises where we're learning to control this movement that little bit better movement from here to here and guess what the exercise so often is the movement itself things like hip hitches are fantastic for just teaching the body to get better at engaging ing through glute M and therefore becoming better at actually controlling the pelvis in this single leg stance now yes we talk a lot about this sort of thing in terms of injury but think about this for a second if the goal is to run down the road run
forwards as efficiently as smoothly as possible if we've got energy effectively being spilt every time we land and load left and right because of poor control in terms of pelvic position that's extra movement the body has to control extra body extra work the body has to do to control that movement and therefore extra metabolic cost on you as a runner if you can control your hips pelvis Lumber spine this whole kind of proximal region this little bit better as you're running through using your core muscles and your glutes in particular that little bit better and
even working on the imbalances we talk about you know tight hip flexes which inhibit glute Max tight adductors that inhibit glut me working on improving those imbalances it's going to help you control that whole region to the point that you won't be wasting so much energy and the energy you do put down will help you head forwards down the road as we want to nice and efficient nice and controlled now there's a PDF worksheet which I'm going to leave a link to down in the description which will walk you through a bunch of different exercises
a bunch of different added resources if you recognize that this kind of hip drop this trendelenberg gate is something that you struggle with yourself or someone's told you you need to work on your hip stability your glutes go and take a look at that it's just going to give you a little bit of a a to-do list in terms of things to go and improve this aspect of your running now if you're a runner who struggles with low back pain this is something I really want you to take note of because we talk in terms
of knee pain because this is something that Scott struggled with but when we see this drop off to the opposite side when we see what again we refer to is this Trendelenburg sign we talk about glut me we talk about this guy we talk about the the drop down here and the way in which glut me should be working to pull down on the pelvis on this side but he not meant to be working on its own got muscles of the lower back on both sides called quadrus lumborum ql here okay so from the top
of the pelvis the bottom of the rib cage now when GL is working here to pull down on the pelvis ql is also working to pull up on the pelvis to create this nice level so glut works to pull that way ql works to pull that way and all of a sudden the power nice and level if glid isn't working then the pull up from ql needs to be a lot more pronounced and we end up over time Runners who are weak here having to work a lot harder here through their L back to create
the stability their body craves that's where if we start throwing a load of mileage at this kind of pattern a lot of the time we get Runners to talk about low back pain either one-sided low back pain which is the classic or both sides um again generically we say you probably not using your your core and your glutes effectively it's kind of true but we can get specific and say well look we need to really work on glute me anyway I hope that helps hope that a little bit of extra Insight adds something um click
the video on screen right now for a full breakdown of another of the most common mistakes that Runners like you and I make that Wast a ton of effort and contributes to injury and I'll see you right over there
