When injuries happen, we often think it is because an area is weak. While that is not necessarily wrong, that is not necessarily the only issue. If it were purely a strength issue, I don’t think we would see as many non-contact and ‘overuse’ injuries happen in professional sports as we do.
So, what is it if it isn’t always a weakness issue? A few things come to my mind as contributing factors: a timing issue between the deep stabilizer muscles and the overlying mover muscles, improper movement patterns placing abnormal forces on different areas, and weakness in the foundation of the body (aka, the feet).
When talking about timing with muscle firing patterns, the deep stabilizer muscles surrounding the joints must fire just before the overlying mover muscles. Those stabilizer musclesput the joint in a stable position so that joint is strong and protected as the overlying mover muscles are moving the area. If the stabilizer muscles fire late, the joint is not as stable and secure throughout the movement. While this can (and does) result in traumatic injury, more often this results in the joint ‘wear and tear’ or ‘degeneration’ that show up on x-rays.
Now, I am sure you are wondering why this happens. Most often, because the timing element doesn’t get trained. We often don’t take the time to slow down movements when learning tasks in order to teach the stabilizers how to kick in first. It is much more fun to just move and not think. When a weight is light or repetitions are low, the body can get away with moving however it wants to move. As the load and volume increase, the body cannot hold up as well, resulting in injury.
Improper movement patterns
The body is great at learning bad habits and compensations. Ultimately, just like you search for ways to make tasks in your daily life easier for yourself, your body does the same thing with movement. Your body finds the ‘path of least resistance’ and creates that habitual pattern, regardless if it is a way that is good for the body.
One reason for these bad habits and compensations is due to mobility deficits. As a very general and simple example, when doing a squat if you don’t have good mobility in the hips and ankles, your low back and knees will compensate. Or for an overhead example, if you are lacking upper back mobility, when you reach overhead your shoulder will have to move in ways that put more stress on the muscles and joints in order to achieve the motion.
Lacking a solid foundation
The feet. I definitely cannot leave these out of the equation. The purpose of the foot is to give us a solid foundation to stand and function on, this includes walking and running. Just like a solid foundation of a building keeps the building strong, a solid foundation of the foot keeps the structure of the body strong. Unfortunately, many people are lacking the strength and control in the foot, both because it is not trained on a regular basis and also because the use of shoes and orthotics automatically weaken the foot.
If the foot loses control, your body loses strength and control in the legs, hips, low back, and even into the upper back, shoulders, and arms. A great example I see often is with athletes strengthening their hips to correct the issue of the knees falling in during squats, but they are unsuccessful with their endeavor. This is because you can have the strongest hips in the world, but if you don’t have good control over your foot, the knee will continue to fall inward. Translate that to running, if you don’t have good control when you are consciously thinking about the movement, you definitely won’t have good control when you have to do things quickly and without thought.
Doing strength work is essential with minimizing and recovering from injuries, but it is not the only element to look at. If you have done the strengthening part and are not seeing results, I encourage you to begin exploring where else you might be lacking.
Written by Brianne Showman. Brianne is a physical therapist and running coach with Get Your Fix Physical Therapy And Performance. Her focus is on helping athletes resolve injuries in less time by getting to the root of the problem, improving movement patterns, and incorporating proper training to help the body move more efficiently, powerfully, and in less injury-prone ways.