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Posted: October 25, 2005

Sports Medicine: Four Simple Stretches To Correct Over-Pronation

By Chris Maund, B.S.

Runners as a group are constantly plagued with a host of annoying injuries, many of which are linked to excessive pronation. Plantar fasciitis, Achilles tendinitis, shin splints and an unending variation of knee problems are just a few of the more common ailments. The majority of these afflictions are dealt with by treating local symptoms. In other words, if you have an Achilles problem chances are that most of the care and attention will be focused on the Achilles area. While treating the symptoms is important, it is also important to address the cause of the injury. If you go to someone for help with an Achilles problem and they only look at your Achilles, I’d suggest finding someone else.

It is my experience that for the vast majority of running-related injuries a more holistic approach (looking at your knee, pelvis, spine and even your neck) will produce faster and more permanent results than the short-sighted approach that is usually taken when dealing with injuries. The reason for this is that in order to treat an injury properly it is necessary to determine the underlying cause of the complaint. Far too many sports injuries are dealt with by treating symptoms without consideration for identification and correction of the underlying cause. This is why so many running injuries recur.

Your Pelvis and Pronation

One of the major control centers in the body is the pelvis. The tilt of the pelvis affects the behavior of the entire leg. To prove this, try the following test:

Stand with your feet about 12 inches apart. Look straight ahead. Hold this position for a few seconds while you take note of how your weight is distributed over the soles of your feet. Now tip your pelvis forward slowly so that you assume a Donald Duck type posture with your chest up and backside stuck out behind you. Note how your weight shifts forward and toward the insides of your feet. Now slowly roll the pelvis backward until your rear end is tucked underneath you. You should notice that your weight moves backward and toward the outside of your feet.

As you tip your pelvis forward your femur (thigh bone) and tibia (shin bone) rotate inward, which produces pronation (rolling inward) of the foot. What you have just proved to yourself is that forward pelvic tilt (rear stuck out) will produce pronation and backward pelvic tilt (rear tucked under) will produce supination (rolling outward of the foot). This is a very important point because most runners who have gait problems are not aware that they can alter their gait through corrective exercises and stretches designed to alter pelvic tilt.

What is the point in trying to control over pronation with a huge heavy shoe or a custom built orthotic without ever addressing a potential cause of the problem up in the pelvis? If your pelvis is tilted forward excessively due to muscular dysfunction and length or tension imbalances, and you prevent your feet from over pronating with an orthotic or a motion control shoe, the knee experiences a lot of rotational forces. The knee joint is not biomechanically equipped to deal with these kinds of forces that are responsible for a significant proportion of runners’ knee problems.

Using the stretches in this article will help to correct your pelvic alignment. If you already wear orthotics to correct pronation or supination, be aware that you will need to have your gait reassessed after a few weeks of performing these exercises since your orthotic prescription will probably change. Some of you may even find that you don’t need orthotics anymore or that you no longer need the biggest, heaviest motion control shoe in the store.

How To Test Your Pelvic Alignment

To determine whether you have abnormal pelvic alignment, perform the following test:

Stand in your bare feet and look straight ahead. Have a partner kneel down on one side of you and palpate (feel by touch) your Anterior Superior Iliac Spine (ASIS) and your Posterior Superior Iliac Spine (PSIS) with the middle finger of each hand. Your partner should note the height difference (in inches) on both sides of the pelvis. (See Photo 1)

Normal pelvic alignment is such that the ASIS (front of pelvis) should be a half-inch lower than the PSIS (back of the pelvis) in males and three quarters of an inch lower in females. If the height difference is three quarters of an inch for males or 1 inch or more for females, then your pelvis is significantly tilted forward. If you over pronate when running, you should find that your excessive pronation reduces as a result of performing the stretches outlined below. If you find that you have less than the normal height difference (less than a half inch for males and three quarters of an inch for females) between ASIS and PSIS you may suffer from excess supination when you run.

The Seven Muscles That Affect Your Pelvic Alignment

There are seven major muscles that will affect your pelvic tilt (See the Illustration below.). If you have excessive forward pelvic tilt (and hence excessive pronation when you run), you will need to stretch your latissimus dorsi, iliopsoas, quadriceps and lumbar erectors. You will also need to strengthen your lower abdominals, hamstrings and gluteals.

When these muscles are strengthened correctly they will tend to rotate the pelvis backward into normal alignment. If you have a backward rotated pelvis and you over supinate when you run, you will need to stretch your hamstrings and gluteals and strengthen your latissimus dorsi, iliopsoas, quadriceps and lumbar erectors.

Four Effective Stretches To Correctly Align Your Pelvis:

1. Latissimus Dorsi

• Keep your rear end in contact with your heels and your arms straight. (See Photo 2 above.)
• Try to make the left arm longer than the right while keeping your backside in contact with the heels. This will produce a strong stretch in the left latissimus dorsi region. (See Photo 3.)
• Hold this for at least 30 seconds, then keep low and walk your finger tips around to the left and repeat for the other side.


• Keep low and return to a central position before lifting the upper body up away from the floor.

2. Iliopsoas


• You should have an angle between 90° and 110° at your front knee. Keep your back leg as straight as possible. (See Photo 4 above.)
• Suck your belly button gently in toward your spine and rotate your pelvis backwards so that you begin to feel a stretch in the front of the right hip. (See Photo 5.)


• Now maintain this position at the pelvis, keep the belly button sucked in gently and side bend the upper body to the left. This will increase the stretch in the right iliopsoas dramatically.
• Hold this position for 15-20 seconds and then repeat on the other side. Do at least three on each side to start with.

2.. Quadriceps

• Kneel down next to a wall and position your body as shown. (See Photo 6) Adjust the distance between your back knee and the wall until the stretch in the front quadriceps is manageable.
• Make certain that you have a 90° angle in the front knee.
• Gently suck your belly button in toward your spine and tuck your rear end under until you feel a strong stretch in the front of the thigh. This “posterior pelvic rotation” is the single most important aspect of this stretch.
• Hold the stretch for at least 30 seconds and perform two to three on each side.
• Do not attempt to increase the stretch by leaning backward. (See Photo 7) This will mobilize your lumbar spine into further extension and you will reinforce the same errors that have led to excess pronation in your running gait. Most people do this stretch incorrectly — don’t imitate this error!

4. Lumbar Erectors

• Squat down as deeply as possible, keeping your feet flat on the floor and hold on to something to prevent yourself from falling over backward. (See Photo 8 above.)
• Let your backside relax into your heels so that your lumbar spine goes into flexion (convex curve) and perform small slow circles with your hips in this position.
• Circle clockwise for 20 seconds then counter-clockwise for another 20 seconds.

Summary

Pronation can have many causes. Often, however, your pelvis will play a large role in the degree of pronation in your body. It is essential that you perform these stretches right before you run so that your pelvis is held in as near normal a position as possible while you train. By stretching in this manner, you should notice a slight change in your posture and running stride. After three or four weeks on your new stretching program, remember to have your gait analyzed and any necessary changes made to the type of shoes you run in and/or your orthotics.

References:

Chek, P. (1997). Gym Instructor Series (video).
Chek, P. (1996). Swiss Ball Exercises for
Athletes (video).
Magee, D.J. (1992). Orthopedic Physical Assessment.
W.B. Saunders Company, 2nd Edition.

Chris Maund is a corrective exercise specialist working at the C.H.E.K Institute in Encinitas, California (www.paulchekseminars.com). He has a Bachelor of Science degree in Physical Education and Sports Science from Loughborough University, England, and is a Level IV C.H.E.K Practitioner. He has extensive experience as both a coach and athlete in running, triathlon and duathlon. For questions, personal evaluations and program design please contact him at the C.H.E.K Institute: (800) 552-8789 or e-mail: ginfo@chekinstitute.com.


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