squat

Lifting and stooping- the latest in lifting related research

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lifting

Should we avoid stoop lifting? There has been plenty of lifting related research in the past but none of it is conclusive. We rely on expert opinion that says the squat lift is safer than stoop lifting but recent discussion amongst clinical experts and researchers surrounds other factors being more important than the classic type of described lift when it comes to avoiding injury. The original review of van Dieen at el in 1999 highlights the very little amount of good quality research existing in the area and recent research from Dreischarf et al 2016 has provided data that challenge existing beliefs on lifting.

A summary on our recent masterclass session on the topic of lifting and avoiding injury concluded the following 5 factors were valuable:

  1. Keeping the load close to the body reduces the forces on the lower back more when compared with the type of lift (stoop vs squat).
  2. Strength and conditioning to the chosen method of lifting is important. I.e. if you never stoop lift and then have to because of where the object is then you are more likely to have an injury than if you stoop lifted more often.
  3. The timing of the movement is important. This is a difficult concept to simplify but refers to when the knees and hips straighten during a lift and what the back is doing at the same time. A common observation in the clinic is that over-arching the back during a lift often leads to pain.
  4. Cumulative loading is important. If you sit and slouch through the pelvis for long periods then it will increase your risk when lifting but if you get up regularly and change posture from sitting to standing or walking then the effect of cumulative loading is reduced.
  5. Semi squat lifting places less stress on the knees than the full squat which is important if you have knee pathology. If the timing is correct and you are conditioned to lift this way it remains the optimal choice of lifting.

For those who are interested, the references referred to in this blog are:

Dreischarf et al, 2016. In vivo loads on a vertebral body replacement during different lifting techniques; Journal of Biomechanics. 49(2016):890-895

Van Dieen et al, 1999. Stoop or squat: a review of biomechanical studies on lifting technique; Clinical Biomechanics. 14(1999):685-696

 

Running biomechanics and muscle strength

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Running physiotherapy injury

 

Biomechanics refers to how we are built and how we move. Some of us have legs that bow out (varus alignment) and others have knock knees (valgus alignment) which relates to the shape of our bone structure. It is a combination of our bony structure and how well our muscles work that can increase the likelihood of injury with running. This blog is looking at key areas of muscle weakness that alter our biomechanics and lead to injury. Your bony structure can’t be changed but improving your strength in the right areas can be achieved within 6 weeks of an exercise program that is designed for you. Assessing the biomechanics of the body combined with a basic understanding of your running style is important if you are serious about running.

A biomechanical physiotherapy assessment considers whether you have sufficient strength and mobility in the right places for running. The muscles in the back of the leg (calf, hamstring and gluteal) are important to maintain strength for running. Weakness in these muscles often leads to pain and injury in runners.

  • Calf muscle and Achilles tendon strength – it is important to understand that both muscles and tendons can respond to the loads we put on them. A simple test and exercise for the calf and achilles is the calf raise. If you can’t do a repeated full height single leg calf raise of more than 6 reps than you probably don’t have enough strength. I encourage people to get to 15 reps and be able to repeat 3 sets as a baseline but there isn’t a magic number here because it also depends on your running style. If you are about to change your style and get further forwards on the forefoot then check your calf and achilles strength first to minimise the chance of getting achilles tendon problems.

calf raise

  • Hamstring strength is essential for fast running but a base level of strength is also important for your park runners to 10km distances. Clearly the most functional way to strengthen the hamstrings for running is to gradually increase the distance and intensity of your running sessions. If you can’t do a hamstring bridge exercise or it takes considerable effort then you need to get stronger. Caution with doing this exercise – if it causes back pain then stop and discuss with one of our physio’s.

hamstring bridge

  • Gluteal (buttock muscle) strength allows for a stable pelvis during running. If you don’t have adequate gluteal strength it puts extra load on the knees, hips and lower back. Unless you have had a biomechanical physio assessment you probably don’t know if your glut’s are working well enough. A glute bridge is similar to a hamstring bridge but the knees are bent at approximately 90°. By bending the knees it makes it harder to use the hamstrings to lift the bottom and thus challenges the gluteal muscles more. Again if you have back pain stop and get some advice.

glute bridge

  • A squat is another good exercise to get the glute muscles working for runners but it needs to be done correctly. Keeping the back straight and bending at both the knees and hips gets the gluteal muscles working. Once you have been taught to do a squat correctly the challenge is a single leg squat with letting the knee drop in valgus collapse.

Squat exercise

Hope you have enjoyed reading about good strength exercises for runners. Thanks to Pete for his stick figure art which has been enjoyed by his clients for many years.