Doctors Rx – Injury Prevention

by Todd Shatynski, MD

Every article you read makes claims about all the things runners should do to stay healthy – often with subjects suggesting a new power food, a superior cross training exercise, or the best exercise to correct all the imbalances from running – it can be daunting to know what is the best, most practical advice.  What shoe is best?  Is there a better way to run?  Forefoot striking?  Optimal stride rate?

From seeing thousands of runners over many years of clinical practice and after reading hundreds of research articles on runners, I have reviewed all of these principles.  I have also tried most of them out in my own running regimen!  While I feel that overall life health is important for running health, it seems that injury prevention boils down to two important principles: single leg balance and hip strength and flexibility.  Of course, this is not to say that shoe choice isn’t important or that diet can’t help you stay healthy.  What I am saying is that your ability to run safely is based on your ability to stabilize yourself on one leg as you “jump from one to the other.”

When looking at an injured runner, I often find that their ability to stand on one leg without wobbling is predictive of an injury.  This seems pretty intuitive but still, most runners have a preferential side.  Try standing on one leg for 30-60 seconds.  Do you have an easier time on one side or are you pretty wobbly on both sides?  This is an easy fix but takes some time.  I recommend multiple single leg balance exercises – from single leg squats, to single leg dead lifts, to even just standing at your bathroom counter on one leg while you brush your teeth!  Eventually you can move up to balance pads or unsteady surfaces to challenge yourself further.  Eventually it will get more stable and easier for you.  As you gain balance, your leg will wobble less when running, reducing leg stress and fatigue.

The issue of “core” hip stability is pretty complex but boiling it down is pretty easy.  The hip abductors (ie glutes) stabilize the hip while on one leg. Their strength is very important.  However, from our day-to-day sitting and our primary forward-moving exercises (running/biking/etc), our hip flexor muscles can over tighten.  When this happens, they inhibit the contractions of those hip stabilizers!  When reviewing all those rehab exercises from the magazine article or your physical therapist, focus on hip flexor flexibility first and hip abductor strength second!  As this improves, your ability to run with a stabile pelvis will improve and risk of lower body injury with decrease!

Remember, everything in life health is important for running health.  However, if you have a finite amount of time, focus on your hip flexibility and strength and your ability to stand steadily on one leg!


Dr. Shatynski has extensive experience in a variety of sports, including football, hockey, and endurance sports. A graduate of Guilderland High School, he enjoys spending time with his wife and three children, as well as participating in running and triathlons. He has completed multiple marathons and Ironman distance triathlons, including Ironman Hawaii.

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