Prevent An Injury When Running On Hills
Injury Prevention For Hill Running
by Eric Oliver, PT, Founder, Running Specialist, USATF Level 1
When running in Cincinnati you are bound to run up and down hills. If you are preparing for one of the local marathons/half marathons you are certain to tackle hills as part of your training regimen. Hill running—even with all of its benefits in developing strength, conditioning, and speed—can be quite damaging to your body if not done appropriately or responsibly.
Four reasons runners develop INJURIES WHEN RUNNING HILLS
There is more tibial (shin bone) stress when running uphill compared to running on level ground.
There are three distinct phases in which the foot is in contact with the ground during the running stride. There is the initial contact phase, the middle stance phase, and the propulsion phase. It is an assumption that the leg is most stressed at the initial contact phase when the foot first strikes the ground. In actuality, the leg is subjected to the highest amount of force during the middle stance phase. It is during this phase when the muscles of the leg are producing a lot of force as they contract. The contraction of these muscles imparts force onto the leg that is actually higher than the ground reaction force. To illustrate this concept, stand on one leg. When you are standing still on one leg, you have 1x body weight of force acting on the tibia. Now, perform a single leg heel raise. Now, you have the force of 1x your body weight PLUS the force of the leg muscles acting on the tibia. In other words, muscle contraction creates more force for the tibia to absorb.
Initial Contact Phase (referencing the near leg)
Midstance Phase
Propulsion Phase
Running uphill requires more muscular effort than running on level ground. This additional muscular effort places more stress on your bone (and the working tendons and muscles for that matter), making you more susceptible for injuries in the leg. If you ramp up your hill training (intensity, volume) faster than your body can adapt, then you increase your likelihood of developing an injury. Additionally, relying too much on your lower leg muscles to propel you uphill will increase your likelihood of getting injured.
Your gluteal muscles are weak.
Yes, you’ve heard this before. But here’s the reason why we need strong gluteals (maximus, medius, minimus) when running uphill. We know that the majority of runners can’t properly activate their muscles and/or they are simply weak in these muscles. Additionally, we understand that the piriformis muscle and the other deep hip rotator muscles can be overworked if the stronger gluteal muscles aren’t doing their job adequately. The muscles of the gluteal region need to be strong and well conditioned because they act as the primary stabilizers of the hip and pelvis during the stance phases of the running cycle. Additionally, the gluteus maximus (along with the hamstrings) assist in pushing the body forward during the propulsion phase.
If you are deficient in strength or ability to activate your gluteal muscles, the following consequences can be:
Increased reliance on your smaller hip stabilizer muscles, causing strains of the deep hip rotators. (ie. piriformis and quadratus femoris strain)
Increased reliance on the hamstrings which can place excessive strain on them. (ie. hamstring pull)
Increased reliance on the lower leg muscles to help support and propel your body uphill, placing excessive stress onto the lower leg. (ie. shin splints, lower leg tendinitis, calf pull)
Your step is too far in front of your body, and you have a slow step cadence.
When you have an extraordinarily long forward step length (foot placement far in front of you) and a low step cadence (steps per minute), this will generally equate to a longer ground contact time for your foot. When your foot is in contact with the ground too long, the amount of force your body is subjected to is increased. When this force increases, your bones, ligaments, tendons, cartilage, and muscles have to absorb it. Excessive amounts of force over time can wear down your tissue, leading to stress and strain that outpaces your body’s ability to repair itself. When this happens you develop an injury. (Learn more about running cadence here.)
These forces and stresses are further magnified when running downhill. The knee joint tends to absorb more of the force when running downhill, which typically leads to various injuries of the knee.
You combine the above factors along with running too many hills in your training regimen.
Many people have issues with their ground contact time, cadence, step length, and gluteal strength. Many of these people are able to run symptom-free, though. That is until they incorporate more hilly routes or hill workouts into their training regimen. When you combine all of these factors, it is a perfect storm for injury development.
SO HOW DO YOU ADJUST YOUR TRAINING STRATEGY TO MINIMIZE THE STRESS PLACED ON YOUR TISSUE?
Manage hills like a boss. When running uphill slightly lean your body into the hill. This will help to minimize the strain of running uphill by allowing you to tap into your bigger thigh and hip muscles to propel you upward. Proper technique when leaning into the hill is to lean from the ankles and not from the waist. To practice this technique stand in place on a flat surface and lean forward 2-3 degrees by pivoting from the ankles. If you do this correctly you will feel your bodyweight shift past your toes, and your toes will slightly grip the ground. Optimized posture will allow you to draw a straight line connecting your shoulder, hip, knee, and ankle while leaning your body forward. Additionally, when running uphill think about pushing into the ground with each step and maintaining short, quick steps.
Running downhill magnifies the forces that are transmitted into your body due to the increased effect of gravity. This places added stress on your bones, muscles, tendons, ligaments, and joints. When running downhill don’t overly reach your foot forward with each step, and don’t run with a slow cadence. Rather, take quick steps (high run cadence). This will help ensure that your foot strikes the ground just in front of your hips or underneath the hips rather than further out in front of you. A quicker cadence will also reduce your ground contact time. Running downhill with a high pace is a skill, and if you are not accustomed to running downhill at a fast pace then reduce your speed without sacrificing run cadence.
Check your ego, and train smart. If you start feeling any aches while running uphill or downhill you should slow your pace (without sacrificing cadence and foot placement), adjust your running route, or if the aches progress you should seek assistance to identify the source of pain. Avoiding hills and speed work can give your body time to heal. When the ache subsides, don’t just jump back into running hills and speed work. The best thing to do is to adjust your training program with the help of a coach so as to not find yourself in the same situation.
[Want more? Learn how to pick out the best road running shoe for you]
About the Author:
Eric Oliver is a physical therapist and the founder of Beyond Exercise, a holistic health and fitness business that specializes in physical therapy, sports performance, and integrative health solutions. Eric is a certified running coach with USA Track & Field and the Road Runner’s Club of America. He specializes is in rehabbing and developing running athletes. Eric is also the director of the BE Racing Team, an amateur racing team comprised of runners, triathletes, and cyclists in Cincinnati, Ohio.
References:
Matijevich ES, Branscombe LM, Scott LR, Zelik KE (2019) Ground reaction force metrics are not strongly correlated with tibial bone load when running across speeds and slopes: Implications for science, sport and wearable tech. PLOS ONE 14(1): e0210000.
Samuel R. Hamner, Ajay Seth , Scott L. Delp Muscle contributions to propulsion and support during running. Journal of Biomechanics. 2010; 43 (14): 2709-2716
Lenhart R, Thelen D, Heiderscheit B. Hip muscle loads during running at various step rates. J Orthop Sports Phys Ther. 2014;44(10):766–A4. doi:10.2519/jospt.2014.5575