14 January 2008
Balance and Stability, an often overlooked training need
Posted by quietseas under: Injuries; Strength Training.
I read something several years back, which was written by Mark Allen, about running. I don’t remember much from the article, but I remember one thing very, very clearly. Allen said “The fastest Ironman runners are the ones who have ran for years injury free.” With the greatest Ironman performances coming from people who are often in their thirties, they have logged a lot of miles and had a lot of opportunities for injuries to accrue.
In running or cycling, there are tremendous forces coursing through your legs as muscles contract, transfering their energy through tendons and their tiny connections to bone to cause movement with force while ligaments are challenged to maintain the alignment of those same bones against ever greater forces exerted by those muscles. The human body is the most intricate machine in existence, and there are countless places an athlete can experience a breakdown. While Mark Allen often refers to balance as emotional and spiritual, I am going to try to give you some simple exercises to provide stability and balance to the muscles of your lower half.
Running and cycling place a lot of strain on the joints, runners often complain of pain in the ankles, knees, and hips. Cyclists are often challenged with knee pain. These pains can usually be traced back to specific muscle imbalances, although they may have culminated in an injury elsewhere, either chronic or acute. For an example, I experienced pain in my right hip last season. The root cause was several-fold, and most were traced back to muscle imbalances and weaknesses in stability. Instability in my left ankle allowed for overpronation which caused my left hip to drop a little with each step; a left-right imbalance between my primary movers (quads and hamstring) led to my right leg doing a little more work with each pedal stroke or step. Finally, a lack of stability work in my pelvis led to further drop in my left hip. Eventually, as I tired during a race, my hip was dropping significantly, placing my right gluteus medius and tensor fascia latae in an overly stretched position (used primarily in pelvic stability while running), and then my over-powered right leg demanded an exertion of power. Something had to give, and I was injured.
I use my story as an example here of how multiple instabilities and imbalances in various locations can lead to pains in other areas. Luckily for us athletes, there are exercises which we can perform to focus on eliminating these imbalances. Even more fortunately, there are a few easy exercises which challenge stability of the ankles, knees, and hips simultaneously. These exercises could be thrown in to your workouts to provide some measure of protection from injury. If you are currently injured or become injured, see a doctor and, likely, a physical therapist to develop a plan for your specific injury. There are a lot more exercises out there that will challenge and speed the recovery of your body, these are just a few which have worked very well for me, and they are not a guarantee.
1. Texas Four-step
Necessary Equipment: Theraband (light, usually yellow, red, or if very strong green), something stable to hook the theraband against, two legs
Method: Tie the Theraband to your stable object so that you have a loop. Now insert your right foot into the loop with your left side toward the stable object. Step away from your stable object to gain some tension in the band. Now balance on your left foot and extend the right foot away from the stable object. Try not to hold on to your stable object unless necessary and maintain good posture. This looks much like common thigh and leg shaping exercises seen in aerobics classes, except with a band. There is a small range of motion, with your right foot coming across your left then out just a foot or two from your body to the right. The right foot remains straight and the motion is VERY smooth and controlled, no jerking whatsoever, leave that for strength days. The overall effort should be very light. Complete twenty repetitions then rotate 90 degrees counter-clockwise so you are extending the right leg behind your body and repeat for twenty repetitions. Rotate 90 degrees again and this time your right leg will be pulling across your left leg for 20 repetitions. Finally rotate 90 degrees again and your right leg will be extending forward against the resistance for 20 repetitions. Then repeat with the left leg. Build up to two or three sets and increased band resistance.
How it works: All that movement in your right leg is really just a trick. You are working the leg which is remaining still beneath you. The trick is that in order to maintain your balance against varied forces from varied directions you must engage the lesser used stabilizer muscles in calves to balance your ankles, the insides and outsides of your thighs (cyclists often have an imblance with strong outer thighs and weaker inner thighs) to stabilize your knees, and numerous muscles which stabilize the hips in relation to both the leg and the spine (glutes, psoas, TFL, transverse abdominals).
Also note: You can make this exercise more difficult by challenging your balance. Yoga has what is known as “Tree pose” where you stand on one foot, the various balance poses really challenge muscle stabilizers! Also, if you want a really tough challenge, try closing your eyes while standing on one foot! You will shut out the visual frame of reference and force your body to rely on proprioception, which is often not nearly as developed, and will cause you to be more out of balance. Also, try performing the above exercises with your foot on a pillow or couch cushion for more challenge.
2. Clock Squats
Necessary Equipment: Two legs
Method: Stand on your right leg, extend your left leg in front of you at the 12:00 position on a clock face. Now squat lightly, only 6-8 inches is all that is necessary. Rotate your leg to the 11:00 position and repeat the squat. Continue around the clock to 6:00, then return. Repeat with the other leg. Again repetitions are slow and controlled without jerking and effort level is light. Posture should remain good with shoulders back and head up. Build up to rotating from 12:00 to 6:00 3 times before stopping, then performing two to three sets of this. For more challenge you can stand on a pillow or couch cusion.
How it works: Similar to the Texas Four Step, this challenges the leg which you are standing on, but addition of the squatting motion helps to engage the larger gluteal muscles while challenging the ankle and knee for stability.
The two above exercise are the first I would add to any routine. The following are some suggestions which focus more on the pelvis, which may or may not be an area of weakness for you.
3. Hamstring Dips
Necessary Equipment: legs and possibly some light weights
Method: Standing on your right leg, lean forward at the hips while your left leg remains aligned with your upper body. Extend your hands forward as a counter-weight to your leg, and bend forward as comfortable, up to about 90 degrees. This looks like something you would see in ballet or figure skating. It is actually very similar to stiff-legged deadlifts if you are familiar with the bodybuilding exercise. By forcing the challenge to come more from a balance/stability aspect, this exercise develops the stabilizer muscles in the glutes. As always, slow and controlled. Perform two to three sets of twenty repetitions.
How it works: The large complex of muscles in the back of the legs not only continue down to connect in the lower leg to cause knee flexion, but also contains muscles which are originate in the hips and insert along the upper leg to provide stability during hip extension. This stiff-legged bend at the waist engages those stabilizers by forcing balance to become a more important part of the lift.
4. Hip abductor/adductor
Equipment needed: Exercise machines or, if you are really creative, therabands
Method: Find the machines that work the inner thigh muscles and outer thigh muscles. Often cyclists will have significantly more power in the outer thighs. These machines are the ones that you spread (abduct) and close (adduct) your legs against resistance.
How it works: These exercise machines work the primary movers for lateral movement. They are also the muscles that are engaged when the body has to use a lot of force to maintain lateral stability.
5. Knee extension
Equipment needed: Exercise machine or theraband
Method: Use the machine unless you are injured, if so, see a doc or PT who will slowly and safely work you up to therabands if appropriate for your condition. This is the machine where you sit and extend (straighten) your knee against the resistance. It is a very common machine. Load the machine with rather light weight, but focus on getting a full knee extension and briefly pausing at that full extension. It will actually take a surprisingly lower weight to be able to lift the weight SLOWLY AND IN CONTROL to this full extension and be able to hold it.
How it works: This is to correct an imbalance within a muscle group, literally a medial/lateral imbalance within the quadriceps. This machine is particularly effective for cyclists, especially those who have patellar (knee cap) pain. The quadriceps (primary movers in squats and cycling) are a complex of numerous muscles, one of which tends to be slightly neglected by those who get the majority of their training on the bike. When the muscles on one side (commonly the outside, or lateral, aspect of the quads) becomes significantly stronger than the other, it can cause the knee joint to recieve tension at an unusual angle. Go look at a picture of a bodybuilder and pay attention to their quads, you will see that, just above the knee, there are two distinct muscle shapes and the one on the inner side of the knee is a tear-drop shaped muscle. That is the specific muscle which may become weaker in some cyclists (possibly due to form and technique, I never found the cause of that one, just what worked for me to fix it) and it is that muscle which is predominately worked by this exercise. The full extension is key to ensuring this portion of the muscle is engaged as completely as possible.
Final Thoughts
There are numerous additional exercises for balance and stability, these are just a few which work a significant number of the stabilizer muscles in your body at once or address common issues. These exercises are a great start to building your balance, joint stability, and injury resistance. This is a great time of the season to begin performing these exercises, so your body is in balance by the time you are ready to begin your hard strength and speed work. These exercises can be done year round as a preventive measure. All of the above exercises are focused on stability and balance, and you can incorporate these principles into other aspects of your workouts: do some lunges or single-leg leg press to compliment your squats and ensure left-right balance, try doing body-weight single leg calf raises with nothing to hold on to so you really activate those stabilizer muscles.
If you are relatively injury free, once a week may be all you need. If you feel yourself to be more injury prone, the exercises are very low impact and are quickly recovered from. Physical Therapists often see patients three times a week or more for Physical Therapy. If you are currently injured, see a doctor! They should refer you to physical therapy. Physical Therapists are wonderful people, and going to PT is like going to the gym, particularly a sports-oriented therapist. They will find ways of moving that challenge you no matter what your skill level is, and physical therapists will work with you tirelessly for months if necessary with one goal in mind: getting you back to peak performance.
Will write more and include pictures later, have to run for now, hope this helps!
13 Comments so far...
Stephanie Says:
Thank you thank you thank you. I really believe that my single-focus on cycling has at caused some hip and knee instability, and that instability is at least part of the isssues I’m having. So part of my focus now is some cross training to regain (or acquire) muscle balance. I’ll keep an eye on your future posts, especially on this topic.
Lisa Sabin Says:
Thank you for this post. I’m an athlete and a personal trainer, who has had her share of injuries. You have to do the balance work and strength training to hold up to the demands of running and triathlon long term. Talent will only get you so far.
hardly Says:
Nice post!
I do remember reading a recent article that was fairly negative regarding the use of the knee extension machine. I’ll see if I can find the source.
hardly Says:
Here’s the source I was remembering, ‘Best Life Magazine’ and the article’s title is, “Is Your Workout Wasting Your Time?” http://www.bestlifeonline.com/cms/publish/health-fitness/Is_Your_Workout_Wasting_Your_Time.shtml
Within the article, they cite a University of Kentucky study where they did a test w/23 patients w/knee pain, and checked which exercise made them stronger: a step-test, or knee extensions. In doing the step test, patients became stronger with respect to functional activities as well as knee extensions. In doing knee extensions, patients only became better at doing knee extensions.
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quietseas Says:
Thank you all for the wonderful comments! It really is proof that a blog site centered around athleticism can work and can provide a wonderful outlet for the exchange of information. Since I wrote this article from a “pre”-habilitation point of view, perhaps the most critical part of the article is in the “Final Thoughts” section. If you can adjust your exercises to include stability, do so. Squat instead of Leg Press, or better do lunges or step-ups. The more “free” the weight, the more you will challenge the muscles in a useful manner, as the article which Hardly cites exbounds upon. You don’t see the big bodybuilders doing a bicep curl machine, you see them curling free weights (this is an isolation exercise, but not so much as a machine, we want to stay on exercises which use major groups). However, don’t go overboard! Remember the SAID principle (Specific Adaptations to Implied Demands). Your body can be very strong in some ways, and very surprisingly weak in others. You may be able to perform a military press with 150 pounds, but don’t expect to jerk a 20kg kettle bell over your head without risking serious injury! Your body will be strong enough to perform the lift, yes, but you need to build those stabilizers. Same goes for most plyometric exercises (go watch the local track team practice and you will see them leaping onto and off of large boxes, or watch boxers and wrestlers toss 12 pound medicine balls back and forth like they are playing basketball), you need to develop the stability to just handle these exercises first, but after you do you can get a whopping boost in performance from them. As a general rule, try to make your gym time more “free” (more stability challenging) than your actual sport. I look forward to writing another advice article and your feedback!
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