Thursday, May 24, 2012

Injury Prevention Work

In my weekly training log, I'll often reference injury prevention exercises.  Ever wondered what those were?  Here they are.

Keep in mind that this is my routine, to address my weaknesses (ankle and foot weakness, glutes that don't fire, a tendency for runners' knee, and poor bone density in my spine).  Everyone's different, with their own areas to target, so these may not work for you.

I split my injury prevention exercises into two categories - "challenging" and "easy".  The "easy" ones are those that don't take much out of me, and that I can do every day without fearing that I'm compromising my recovery or taper for my next race.  (and I do try to do them daily)

The "challenging" ones are more physically demanding -- I always do these immediately after my hard running workouts, as the final part of the workout.  That way, I have the maximum time to recover before my next hard running workout (and running IS the priority).

Easy  I shoot for doing these daily, or at least 5 times a week. They don't drain me, so the only reason not to do them is time.  And I've decided that the time spent doing these regularly is more beneficial to my overall running progression than an extra 5-10 easy miles a week.  First rule of improving in running - don't get injured.
Bosu.  I have the flat side up
  • Hip hikes. Video here.  Balance on one foot barefoot, and "hike" the other hip for one minute while maintaining correct posture (important).  I do for 60 seconds on each side.  Good for stability and glute activation, plus foot strength.
  • Balance on one foot on bosu. Take a bosu, and turn it round side down.  Then balance on one bare foot for one minute while swinging the other leg like you were running.  Again, posture is key.  Addresses the same issues as the hip hikes.
  • Stool dips.  These are a great exercise that target the glutes and quads, but also get the feet and lower legs.  I balance, barefoot, on a 12 inch plyo box.  I then balance on top of the box/pad on one leg, with the other leg held straight and extended in front of the box.  Then, I bend the knee on my standing leg and perform a controlled single leg squat until the heel on the other leg gently touches the ground, then rise back up.  I do 10 of these on each leg, and then a second set with my dangling leg to the side (rather than to the front).  Big point again is to maintain correct posture and not let one hip or the other collapse.
  • Balancing with my eyes closed.  My nemesis.  I've programmed my Garmin to a "workout" of 8 times 25 seconds on, 5 seconds off.  The Garmin vibrates at the end of each 25 or 5 second interval.  So, start the Garmin, and balance on one foot with my eyes closed for 25 seconds.  Then take the 5 second break to open eyes and shift to other foot.  I do these barefoot.  And I stink at them.  But I will master them.
  • Picking up stones with feet   I keep a small tub full of stones near my sofa.  When I get a few minutes free, I empty the stones onto the floor and then pick each up individually with my feet to return to the tub.  The purpose is to strengthen my feet.
  • Towel scrunches  While my breakfast cooks in the microwave, I toss a towel on the floor and scrunch it up under my toes.  Again, feet strength.
  • Toe yoga.  Name for this was coined by my PT.  Push big toe down for 5 seconds while lifting other four toes up.  Then lift big toe up for 5 seconds while pressing other four toes down.  Repeat for 2 minutes.  Added bonus is that you can do these at any time -- those of you with office jobs and closed toe shoes could even do during meetings.
  • Foot band exercises.  This is ankle inversion/eversion, using a theraband (those latex stretchy bands).  First, tie a loop in one end of a theraband, then tie the other end to something.  Now, stick your foot into the loop, so that the band is around the foot roughly half-way between toes and heel.  Move far enough back that there is tension in the band, then slowly first "invert" your foot against resistance (move the inside of your foot more to the inside) for a set of reps, then "evert" your foot (move the outside of your foot more to the outside).  I do 20 reps each of inversion and eversion on each foot, for 80 reps total, on a daily basis. (here's another article explaining).   These work the anterior tibialis, the peroneals longus and brevis, and the posterior tibialis.
  • Eccentric calf dips Video.  These are the gold standard for addressing (or preventing, which is even better) achilles tendonitis.

  • I use a body bar like one of these
    for my anterior tibialis
  • Anterior tibialis lifts.  This strengthens the anterior tibialis muscle on the outside front of the shin.  I take a body bar, and (while standing) place one end on my toes while holding the other end of the bar in my hand.  Then I lift the bar with my toes.  I do sets of 10 reps; weight between 12-15 pounds.

  • Marching glute bridges and side planks with leg lift.  For engagement and strengthening of glutes medius and maximus.  My PT explains them very well, so I'll send you to his write up (go to pages 10 and 12).  I aim for 3 sets of 10 for each daily.

  • Single leg deadlifts  Balance on one nearly straight leg while holding a weight (dumbbell or kettlebell)  in one hand, then lean forward (keeping torso square) while simultaneously lowering the hand with the weight to the floor in front of you and raising your other leg behind you.  Here's a good description.    It's key to keep the movement controlled and your core engaged, with hips level (no twisting or rotating). This forces your core and glutes to work together, and also makes your feet and lower legs work some to stabilize you.  I do these everyday with light weight or no weight at all as an "easy" exercise that challenges balance and coordination.  Increase the weight, and you have a more challenging exercise (see below).

Challenging  As noted above, these are the exercises that are beneficial, but also can tire me and fatigue the same muscles I use when running.  In order to ensure that these DON'T compromise my running workouts, I do these immediately after my hardest running workouts (intervals, tempo, long run).  That way, I have the best chance to recover from them before the next workout  Effective training isn't just about stress, but about the proper balance of stress and recovery; doing squats on an easy day is a good way to compromise your training. 

And of course, since the goal of these is injury prevention, I skip them if I feel that I tweaked something during a workout.  It'd be pretty stupid to get injured doing the very thing that's supposed to keep you healthy.
Ye olde power cage.
  • Barbell squats.  Pretty self explanatory.  Set up power cage, weight up the bar, and squat.  I do in sets of 8 -- if you must know the #s, I start at one set of 8 reps of 115 pounds, and then up the weight by 5-20 pounds for each successive set - usually ending anywhere between 145 and 155.  My goal in doing these is to place weighted stress on my spine to encourage bone density there (I have osteopenia in my spine that's close to osteoporosis levels, so this type of work is really important).  I only squat to barely parallel; since my goal is spine loading, I'd rather get more reps with a more limited range of motion.

  • Good mornings.  Another good one for placing load on the spine.  Video here.  I do for 2-3 sets of 10 reps, usually between 95-115 pounds. 
  • Single leg deadlifts.  Same as above, only I use a heavy weight - up to about 35 pounds if I'm up to it.  This is great for making your glutes medius and maximus coordinate with your core.  I hold the dumbbell in one hand only, which makes me work a little harder to keep balance, since the single weight pulls me to the side.  I'll do this both with the weight in the same hand as the leg I'm balancing on (right hand, right leg) and opposite hand and leg.

  • Quad presses with limited range of motion.  I have a slight tendency towards runners knee, with a very clear cause -- my vastus medialis ("VMO") muscle on the inside of my thigh tends to get weaker than my other quads, with the result that my knee cap gets pulled slightly out of alignment.  Very easy fix -- keep the VMO strong.  So I sit on a leg extension machine and isolate the VMO by working a very small range of motion - just from knee almost straight to knee straight.  If you increase the range of motion by bending the knee more, other muscles get engaged, so it's better to stick to a very narrow range of movement, and pulse the muscle within that range.


  1. Ooh these are really good and I should probably do them're so on top of this stuff! :)

  2. Good stuff, Cris! I have a love/hate relationship with the Bosu ball. I find the easiest exercises are so boring and hard to motivate myself to do them, but are so beneficial.

  3. I'm very pleased to see that I already do a great deal of this routine - although frequency has dropped recently as IM training has kicked up. The single leg deadlift is my favorite - it activates my glutes like NOTHING else!