Author archive for Gabe Yankowitz

Several entries in this series have covered the connection between muscle imbalances and faulty movement patterns of the hip with the development of assorted overuse injuries commonly incurred in the lower extremities.

The prevalence of these problems in the female runner has usually been attributed to the wider pelvis in women, though by itself, this characteristic does not necessarily mandate an abnormal gait muscle weakness pattern. Additionally, not all women display this structure; elite athletes,especially, seem to have narrower hips than the general female population, yet they still seem susceptible to the same injuries.  And, since the width of the pelvis is generally equal on both sides, this feature by itself does not explain the clinical finding of injuries usually occurring on one side only.

As previously noted (Article #89), one prevailing theory for this phenomenon argues that women develop these unilateral imbalances because of postural habits that differentiate them from men.  A specific example described in that column pertains to standing postures. When talking to someone, for instance, men usually stand with their weight evenly distributed between the two lower limbs.  Women, on the other hand, usually stand with most weight on one leg or the other, with the opposite knee slightly flexed.  Overtime, one leg becomes favored and an asymmetric pattern develops.  As the pelvis drops in that position and the leg internally rotates, the overstretched external rotators and abductors of the hip become functionally weak and a faulty movement pattern is born.

Changing such a pattern can be difficult, especially since it seems to be reinforced, if not driven, by cultural expectations.  Women may resist standing with both feet equally apart, hands on hips like Superman, but they can at least try to be aware of balancing the time spent on each limb.  (They can also try to offset the effects by performing the strengthening exercises described in that column.)

Another postural habit that may contribute to this common imbalance is the manner in which women cross their legs when sitting.  While men often cross their legs by placing the ankle of one foot on the opposite knee, women of course simply place one knee over the other. The lower thigh in this instance is pulled inward and internally rotated, causing a similar overstretching of the outer hip muscles.  (While many men sit in a similar manner,their legs are not pulled in as much due to their narrower pelvis.)  Again, changing this position may be seen as”culturally unacceptable,” but, as with standing, it can be modified and balanced through conscious effort.

Finally, there is the problem created by the wider pelvis when sleeping on one side.  As the top leg is brought up into a flexed position over the straighter lower leg, it tends to fall forward and down to a greater degree than a man’s leg does, bringing the hip into that same inward and internally rotated position.  Since most people tend to favor one side over the other for sleeping comfort, it is not difficult to see how this can become even more problematic than the similar standing or sitting posture, since it is done for a greater period of time.

An easy solution exists, however, in the form of one of two pillows placed between the knees. This effectively keeps the hips in a neutral position in two planes of movement and eliminates the prolonged, dysfunctional stretch to the muscles that are crucial in maintaining optimal balance and movement patterns of the hip when running.