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3 Single Leg Exercises to Reinforce Good Lower Limb Alignment

April 23, 2019 · by Garrett McLaughlin

Article written on April 22nd, 2019 at 02:59pm | Follow Garrett on Facebook and Instagram |

Running is such a dynamic activity that requires stability, balance, and alignment as you bound from one leg to the other. That’s why focusing on these characteristics within your strength training program can make a huge impact on how well you function on a single leg. That is, if you address them properly…

When we look more closely at alignment of the lower limb, it becomes clear that emphasis needs to be placed at the foot and hip. These two areas ultimately control the knee joint, which most people consider the culprit for poor alignment at the lower extremity. Although there is a small degree of tibial (knee) internal and external rotation which could impact alignment, it’s more likely a stabilization issue at the medial longitudinal arch or posterolateral hip musculature. These areas need to possess proper feed-forward and feedback mechanisms during late swing phase, foot strike, and midstance. Basically, they provide input to the nervous system in preparation and response to movement/joint position to maintain optimal alignment of the limb.

Over the years, I have tested a variety of single leg movements on my running clients to determine which will provide the best bang for your buck. In doing so, there have been three which have shown consistent, positive results. Of course, your exercise selection should target your goals and body’s specific limitations. However, from a general standpoint these three exercises are well worth your time if you want to improve stability, balance, and alignment. They include:

Lateral Toe Taps with Band
Lateral Step Down
Slow Eccentric Step-Up

To best explain the key points of each exercise and why they matter when it comes to stability and alignment, I’ve included a video below which will teach you how to perform each one correctly and with the most success. The next step is for you to stay consistent over the next few months and emphasize good control to see positive results and carryover to your running.

Thanks for reading about single leg alignment and stability. I hope this article highlighted it’s importance when it comes to running and being more efficient on a single leg. If you have any questions, please feel free to comment below or contact me directly.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Assessing Hip Stability with the Lateral Step Down

April 17, 2019 · by Garrett McLaughlin

Article written on April 17h, 2019 at 03:57pm | Follow Garrett on Facebook and Instagram |

Hip stability is super important for runners. But, how do you know if you are proficient in this area without paying a healthcare professional a costly amount of money for an evaluation? Easy! You complete the lateral step down assessment…

The lateral step down is a very simple movement that you can use to build strength, stability, and balance that carries over to running. Or, it can provide insight into how well you are positioning the body on a single leg which relates to the initial foot strike and mid-stance phases of gait.

How to complete the lateral step down assessment…

Find a box or stair that is approximately 4-8 inches in height
While balancing on the platform, lower down until the non-stance leg touches the ground
Make sure to do so slowly and lightly touch the heel to the ground
Rise back up to the starting position
Assess if one or more of the following things happen:
- Inability to maintain balance and complete the movement for 10 repetitions
- Shifting or tilting of the body over the stance leg
- Inability to lower all the way to the ground
- Noticeable loss of the levelness at your pelvis (drop on the non-stance side)
- The hip internally rotates and therefore the leg does not stay aligned
- Inward collapse of the knee and therefore the leg does not stay aligned
- Collapse of the medial arch and flattening of the foot
Record the results
Complete on the other side

When performing the lateral step down, there are two different positions which could be valuable to assess. The first being more of a hip-dominant position where you slightly sit back into the hip and lower down. The second is with a vertical posture that allows the knee to travel over the toes. Both of these can provide important information on how well you stabilize in a hip versus knee-based strategy.

Want to learn more about hip stability and how to complete the lateral step down assessment? Click the video below to watch the assessment in action before trying it for yourself.

I hope this article helps you determine if more attention needs to be placed on improving lower extremity stability and balance with the lateral step down. For runners, this can shed some light on how efficient you are on one leg.

If you noticed one or several of the positive signs outlined above, make sure to add single leg training into your routine to resolve this weak link. As always, please comment below or reach out directly with questions.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Why You’re Not Seeing Results From Foam Rolling

April 10, 2019 · by Garrett McLaughlin

Article written on April 9th, 2019 at 09:16am | Follow Garrett on Facebook and Instagram |

Foam rolling has grown in popularity over the years and for good reason. It’s prescribed and utilized to combat aches and pains, reduce soreness, and loosen tight and restricted muscles. But, what does the evidence actually show about foam rolling and it’s overall effectiveness?

Before reading further, please realize that I have no problem with foam rolling whatsoever. You will find people in the healthcare/fitness world who love it and sing it’s praises. While others will quickly object to any long-term benefit from using this device.

I typically adopt a research-based perspective but also encourage people to form their own opinion based on their experience. Basically, I know what the research says and am also open minded to the neurophysiological effects that keep people coming back for more.

The Journal of Strength and Conditioning Research completed a fantastic review of literature that looked at the impact of foam rolling on flexibility, athletic performance, delayed onset muscle soreness, and balance. Here is a link to the review of literature. And, below is a summary of the findings…

Acute Effects on Flexibility

12 of 14 studies showed significant increase in acute flexibility.
Self-myofascial release appears to increase flexibility acutely for up to 10-minutes post-treatment.
Did not identify any consistent dose-response effect on flexibility by altering the duration of treatment or number of sets. Reported a tendency for total duration to have a greater effect on flexibility than the total number of sets.
Foam rolling produced non-local effects and increased flexibility on body parts that were not treated directly.
Conclusion: Foam rolling can cause an increase in short-term flexibility that lasts approximately 10-minutes. There is no specific dose-response consensus on how often or how long to foam roll for optimal results. And, foam rolling does not need to be performed on the specific muscle you are addressing since it seems to have a non-local effect on flexibility.

Acute Effects on Athletic Performance

No adverse effect of foam rolling on athletic performance as compared to static stretching.
One study found an improvement in athletic performance following foam rolling.
Conclusion: Foam rolling doesn’t reduce athletic performance (power, velocity) when performed beforehand.

Acute Effects on Delayed Onset Muscle Soreness (DOMS)

3 out of 4 studies report that foam rolling does reduce the perceived sensation of delayed onset muscle soreness.
Most studies concluded that the only reliable method to reduce DOMS is exercise.
Conclusion: Foam rolling does seem to reduce the pain perception related to delayed onset muscle soreness. Although most studies state that exercise is the most reliable method.

Chronic Effects on Flexibility

3 of 5 studies report that foam rolling leads to increased flexibility over long-term periods of time (>2-weeks).
One study concluded that the long-term improvements were comparable to the proprioceptive neuromuscular facilitation (PNF) stretching program.
Conclusion: Foam rolling does show increased flexibility greater than 2-weeks. This effect is similar to PNF stretching protocols.

Chronic Effects on Balance

Rolling with a tennis ball led to increased performance on a balance test in chronic stroke patients.
Unfortunately, there was no control group to determine if rolling was the cause or the normal course of the condition.
Conclusion: Minimal research on non-injured subjects to conclude one way or another, besides it may improve balance in stroke patients.

Other Effects of Foam Rolling

Found to reduce brachial-ankle pulse wave velocity, increase plasma nitric oxide concentration, reduce cortisol levels, and increase high frequency heart rate variability percentage, and reduce low frequency heart rate variability percentage.
Conclusion: Foam rolling may reduce parasympathetic nervous system activity.

Now, with all that being said, it’s obvious more research needs to be done on foam rolling. There is minimal consensus outlining the long-term benefit, how frequent to foam roll, the duration on each area/tissue, how many sets throughout the day, the speed of each repetition, etc. Therefore, much needs to be understood and further researched for us to know more.

One thing we need to take into consideration is that movement, exercise, mobility, balance training, and other active strategies have been shown to provide positive results. That’s why you should place priority on active interventions to move closer to your end-goal. And, if you want to include any type of passive intervention, such as foam rolling or self-myofascial release, do so in conjunction with an active intervention. This combination should provide more reliable long-term results not seen by foam rolling.

Watch this video to learn more…

Depending on when you read this article, there may have been further research done to either reinforce what has been found or negate it. Either way, I hope you found this article helpful in some way. Please comment below or reach out directly with more specific questions.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Self-Assessing Gluteal Function

April 9, 2019 · by Garrett McLaughlin

Article written on April 8th, 2019 at 03:23pm | Follow Garrett on Facebook and Instagram |

The gluteals are comprised of 3 muscles at the posterolateral aspect of the hip. These muscles include the gluteus maximus, gluteus medius, and gluteus minimus. Due to their location and connection between the pelvis, sacrum, and femur, they function in hip extension, abduction, external rotation, and internal rotation. But, they are also important from a stabilization standpoint, as they prevent hip internal rotation and help to align the lower limb during single leg stance and running.

I bet, at one time or another, you have heard how important these muscles are for everyday movements, athletics, and running. But, have you ever performed any type of assessment to truly test their integrity? If not, I have a very simple self-assessment that you can complete in 60-seconds or less. It’s called the hip bridge with straight leg raise.

How to perform the hip bridge with straight leg raise…

Lay on your back with the knees bent and feet flat on the floor
Lift up your hips to assume a hip bridge position
Extend one leg at the knee joint so the thighs remain level but you are supporting from one side
Hold this position for 20-30 seconds
Assess if one of the following things happened:
1. Inability to raise the hips up to the point where the knees, hips, and shoulders are in a straight line
2. The pelvis rotated and the non-weight bearing side dropped closer to the ground
3. The hamstring on the support side became very tight and/or cramped during the test
4. You were unable to hold this position for a minimum of 20-seconds
Now, complete the same assessment on the other side
Record the results and compare left to right

Take a second to watch the following video on how to self-assess the gluteals…

Because the gluteals play a variety of roles around the hip, this self-assessment could have shown you poor stabilization, hamstring dominance, poor neuromuscular control, gluteal weakness, or all of the above. Once you have improved the weak link(s), the next step is to build overall strength, stability, and endurance with a structured and progressive lifting program. This area can never be too strong and resilient!

If you found any issues with the self-assessment outlined in today’s article, I highly recommend reaching out to a knowledgeable healthcare professional who can help you create an action plan to see reliable results. Please click here to contact me directly if you have questions or want to work more closely together to find a solution.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Do You Have Enough Ankle Dorsiflexion?

April 4, 2019 · by Garrett McLaughlin

Article written on April 4th, 2019 at 08:25am | Follow Garrett on Facebook and Instagram |

Over the years, I have had so many runners ask me for the best stretches to increase range of motion at the quadriceps, hamstrings, lower back, etc. What I try to make them realize is that running is a very mid-range activity. That means it does not require a whole lot of motion at the knees, hips, and spine. Unless we uncover something significant that is limiting their running or affecting their daily life, we usually stay away from a lot of flexibility work in these areas.

With that being said, there are two areas which absolutely need adequate range of motion. Those areas include the great toe and ankle. Once you get into late midstance, the body travels over the foot (ankle dorsiflexion) and is followed by loading into the great toe for push-off (great toe extension). Lacking dorsiflexion and great toe extension can really impede a fluid running cycle and cause early push-off that lacks power and authority.

In today’s article, let’s look more deeply at how to self-assess ankle dorsiflexion. In terms of dorsiflexion, we need to take into consideration the ankle joint capsule, and calf complex (gastrocnemius and soleus). Luckily, this can be done with a simple self-assessment in the comfort of your home. The goal of the self-assessment is to be able to keep the heel on the ground and touch the knee to the wall from the 4-inch mark.

Here’s how to self-assess your ankle dorsiflexion range of motion:

Get a ruler, piece of white tape, and pen.
Place the tape against the wall, running in a perpendicular direction.
Use the ruler and place markings at the following increments from the wall: 1-inch, 2-inch, 3-inch, and 4-inch.
Assume a lunge position with your back knee down on the ground.
Place the toes of your front foot on the 4-inch line and square your body with the wall.
Lunge the knee forward in an attempt to touch the wall, while keeping the heel flat on the floor.
Does the knee touch the wall without the heel lifting up? IF SO, you have adequate ankle dorsiflexion. IF NOT, move closer to the wall inch-by-inch and re-test to determine your ankle range of motion.
Record this measurement.
Complete on the other side.
Record this measurement.

For a more detailed explanation on the importance of ankle dorsiflexion for runners and how to self-assess range of motion, take a second to watch this video…

By now I hope you have taken the time to self-assess your ankle dorsiflexion. Lack of motion here due to stiffness in the calf complex or a restricted ankle joint can be detrimental to your running performance.

In order to improve the limitation which was uncovered by completing the self-assessment, I highly recommend consistent calf stretching exercises and the wall ankle mobility drill. Doing these a minimum of 2-3 times per day is what’s needed for reliable results. After 4-6 weeks of consistent attention, complete the self-assessment again to gauge progress.

Do you suffer from limited ankle mobility that’s negatively impacting your performance? Or, a chronic foot, ankle, or knee injury that may be a result of poor mobility? Please click here to reach out directly so we can troubleshoot and get you on track for success.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Pelvic Position During Single Leg Stance & Running

April 3, 2019 · by Garrett McLaughlin

Article written on April 3rd, 2019 at 11:21am | Follow Garrett on Facebook and Instagram |

The pelvis is an important player that connects the lower extremity and trunk. Therefore, it deserves attention and respect when emphasizing proper biomechanics and movement. This is especially true during running and single leg stance.

The first thing to consider when it comes to positioning of the pelvis is it’s levelness during single leg activities, such as running, walking up/down stairs, strength training, etc. Poor stability and control surrounding the pelvis can present as a positive Trendelenburg Sign. This term refers to a position where the opposite side pelvis, from that which you are standing on, is actually dropped in a lower position (see image below).

When this happens, stability is inadequate and more stress will likely be loaded onto the hip, spine, and lower extremity. Not to mention it is very inefficient and can be a contributor to lower back pain, hip bursitis, gluteus medius tendinopathy, and patellofemoral syndrome.

What can you do about it?

The first step when addressing pelvic control and stability is teaching the pelvis how to be properly positioning during single leg stance. The hip hike walking drill is very neuromuscular and reinforces the ‘opposite side lift’ that should happen when in single leg stance.

One thing to realize with this drill is that is does not need to be exaggerated. The opposite side pelvis should be level with or slightly higher than the stance side. As long as it is doesn’t drop, then you are in a good position for success.

From there, increasing the demand by holding single leg stance is important. Since I’m a huge fan of marching drills, you can simply perform a hip hike followed by a sustained hold in the marching position. This can be performed for a series of repetitions and even loaded with one or two dumbbells to challenge the position. Once loaded, maintain emphasis on position of the pelvis and don’t just stand haphazardly on one leg. The position is what matters!

In the following video, let’s talk about the importance of pelvic position during running and single leg stance. Also, the hip hike walking and hip hike to single leg stance drills will be explained in greater detail.

Now that you have a better understanding of proper pelvic position while in single leg stance, it’s important for you to implement this concept within your strength training program. Exercises that require positional control at the pelvis are lunges, step ups, step downs, single leg squats, etc. So next time you perform any of them, make sure you reinforce the position of the pelvis so strength and stability can be built around it. This will help create the best long-term success and resilience to injury.

Have any questions about this topic or currently struggling with lower back, hip, or knee pain? Contact me so we can evaluate the pelvis and surrounding area to determine the best course of action to become pain-free and/or improve running performance.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

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