I am leading a 5k Training Program for @runningproject, and in conjunction with that will be posting helpful information to my blog during the next 12 weeks. Follow along with the training program, post your workouts, and get ongoing guidance from me and support from runners from around the world!

What is Prehab?

Prehab is short for pre-habilitation, and refers to various things we can do to prevent injury during athletic activities.

Why Do Runners Need Prehab?

A healthy person with the appropriate muscle strength, flexibility and stability should have no difficulty running in a straight line for at least short distances. However, very few, if any of us, have perfect physical fitness Lack of strength in one or more key muscles, a lack of stability, or a lack of flexibility can lead to overuse injuries relatively quickly. Furthermore, runners sometimes believe they are in great shape and do not need to do anything besides run. If I want to be a good runner I should just run, right? Well, not quite. Running is indeed great exercise, but moving in a straight line on a relatively flat surface doesn't work all of the muscles necessary to support that movement completely. Prehab helps develop and maintain strength, stability and flexibility, so that the body can withstand the stress of the activity, and truly benefit from it.

Personal Experience

I am an experienced runner and coach, and I have lived through many of my own mistakes. When I was younger I didn't have to think very much about injuries, but when I started to get more serious about my own fitness in my mid 30s, I experienced a string of injuries that almost led to quitting running altogether. However, by learning and practicing better technique, and by paying more attention to strength, stability and flexibility in my entire body, I have been able to enjoy the health benefits of running with very little interruption. As a high school track coach, I have lived through the evolution from the time when we told kids to static stretch before running, and did almost nothing else besides stretching and running, to now, when we have kids spend almost half their training time doing plyometrics and drills. The result is that with each passing year as a coach, I have experienced less and less injuries among my team. The point is, we are all learning, and I don't know that I will ever be done learning better ways to stay healthy as runners.

First Thing First: Posture

The very first thing we need to become more aware of and begin practicing, especially as new runners, is good, athletic posture. The more efficiently we move our bodies, the more in tune we are to how our bodies were designed to move, and the less likely we are to use the wrong muscles in the wrong ways and become injured. So, by correct posture, I mean that we are standing upright, and distributing our body weight evenly through both feet. From there, all motion is forward and rearward, with minimal to no lateral motion. If we want to move forward, then our limbs should only move forward and backward. If you have difficulty standing with good poster, or walking/running with minimal lateral movement, it means you have a lack of strength in one or more key muscles, or a lack of stability, or a lack of flexibility, or a combination of all three.

Try standing in place, with your feet parallel and hip width apart. Hands and arms at rest, with the thumbs resting at the center of each thigh. Rock forward and backward to feel the pressure of the ground on the bottom of the feet, and feel the pressure shift from the heels to the balls of the feet, and then come to rest evenly. Then rock side to side, feeling your weight shift, and again come to rest evenly. Now lengthen your spine by breathing in and just gently making yourself as tall as possible. Your head should be in a neutral position and the neck relaxed. In this tall position, your shoulders are over your heels. Now, turn your awareness to your navel, or belly button, and imagine you are lying flat on your back and about to do a sit up, or a crunch. With just a bit of tension in your core/navel area, lean forward slightly at the waist so that your shoulders move over the center of your feet. This is a very slight shift in posture -- again, the shoulders shift from being directly over the heels, to directly over the middle of the feet.

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This shift allows you to engage your core, and hold your posture in position while moving. In this position, walk slowly. You may feel a little stiff, so consciously relax, and walk as normal as possible while holding the posture. Take very small steps, so that you are not reaching far in front of your body with your feet. As you walk, allow yourself to fall forward slightly from the ankles, and just allow each step to land directly below your center of mass. From this position, you can begin running by simply lifting your heels gently.

Your arms are the last part of the overall posture. Standing still, just bend your elbows as naturally as possible to 90 degrees. This should bring your hands inline with your nipples, and if you make relaxed fists, your knuckles will be close to the edges of your breast bone.

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When you run, simply pull your elbows gently to the rear. You hands will move forward and backward at about a 45 degree angle to your torso (not a 90 degree angle, like a robot). One way to check this motion is to open your thumbs up a little, and allow them to drag along your lowest rib as you swing your arms forward and backward. This is getting a little ahead or ourselves, but when we get into proper running technique, we can imagine that all we are really doing is falling gently forward while picking up our heels and pulling our elbows to the rear.

Stability Test

While practicing your good athletic posture (remember to keep the core engaged), try simply lifting one heel straight up to your butt while standing on one leg. Imagine a string being attached to your heel, and then running straight through the corresponding butt cheek. Pull the string up, and your heel just rises up.

Standing in this position might look like a flamingo standing on one leg. Try both legs, and as you get the hang of this simple, gentle motion, walk in place doing the same. Now, the test. Lift one heel, and see how long you can hold it without moving. Then try the other leg. If it is your first time doing this, chances are you will at least rock a little on your feet as you find your balance. The extent to which you are able to do this, or not, is an indication of your stability. There are many other aspects of muscle stability as it pertains to running, but standing on one leg is the most central, as running is pretty much just planting one foot down at a time to support your body weight as it moves forward.

More of a test of flexibility, try squatting as low as possible while keeping your feet flat on the ground.

And last, try bending only at the waist and touch your toes.

If you have difficulty squatting or touching your toes its a sign that you need to work on basic flexibility. If you are not in pain or already dealing with an injury it is okay to run, but you should start doing the exercises below right away. Even if you can do the tests above, these exercises are some of the most common that physical therapists recommend for runners to maintain strength and flexibility in muscles and joints that end up neglected by only running.

Prehab Plyometric Exercises

Plyometric exercises will help develop overall core and key muscle strength. Most of the stretchy band exercises help develop hip strength, which is essential for increasing stability and minimizing lateral motion. My favorite strengthening exercises for my track athletes are all quite simple, and most require the use of 12" stretchy bands. CLick here to see an inexpensive kit on Amazon.

Here are a few of the exercises we do before almost every practice, after a light walking and jogging warmup.

1. Squats
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   With the band around both legs just above the knee, begin with a bit of a stretch in the band which activates the hip flexors. Feet are hip width apart, and feet are in a symmetrical position, with toes pointed out about 5 degrees. Bend the knees and squat until your knees are bent 90 degrees. Make sure you are sitting back far enough that your knees do not move forward past your toes. Do 10-15 squats.

2. Side-Walks
   With the band around both legs at the ankles, stand tall with glute muscles activated (clenched slightly), and step to the right 10 times. One leg extends straight out from the body, and then the other leg follows. While stepping, keep your upper body straight and not swinging side to side. Take 10 steps in one direction, and then 10 back in the other direction.
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3. Clam Shells
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   Lying on the ground on one side, place the stretchy band around both legs just above the knees. With you body in a straight line, and leaning on your bent elbow for support, bend your knees 90 degrees. Your knees, hips and head should be in a straight line. In this position, open your knees by keeping one leg on the ground and pulling the band apart with the other, like a clam shell opening and closing. To add some difficulty, go into a side plank and do the same motion (below). Do 10-15 reps on each side.
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4. Alphabets
   With the stretchy band around both ankles, stand straight and tall, and begin by pulling one foot back and at a 45 degree angle 10 times. Then while still standing on the opposite leg, spell out the alphabet with the other foot, keeping your leg straight at all times. Switch legs and do the routine again. The photo below shows the first part of the exercise - pulling the leg back ten times at a 45 degree angle. When drawing the alphabet, don't sweat your penmanship - the point is just to keep moving the hip in random directions for an extended amount of time.
   

5. Bridges
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   Lying on your back with the stretchy band around both legs just above the knee, bend your knees 90 degrees and keep your feet flat on the ground. From this starting position, put a little stretch in the band and raise your hips up off the ground until you are in plank position. Keep your arms slightly raised off the floor, using your shoulders only for stability. Hold the position, with tension on the band, for 5 seconds. Return to the starting position and repeat 10-15 times. Add difficulty to this exercise by raising one leg at a time into a straight leg position with each rep.
   

6. Lunges
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   No stretchy band. Standing tall, reach one leg forward by lifting the knee up, stepping forward, and placing the foot down in front of your body, then dropping the other knee down until it touches the ground. Using the glute muscles, stand back up and repeat the stepping motion with the opposite leg. Do 10-15 of each leg, walking forward with each step.

7. Planks
   
   Front plank: Beginning on a push up position, but with the elbows on the ground and hands forward and clasped, hold a plank position for 30 seconds (increase hold time as you get stronger).
   Side plank: Begin lying on one side, with bent elbow supporting upper body. Lift up into a plank position and hold for 30 seconds. Switch sides and repeat.
   

8. Deadbugs
   
   Lying on your back, engage your core by pressing your lower back flat to the ground. It is important to have the core engaged during this exercise to prevent lower back injury. Raise one leg and hold it with the knee bent 90 degrees, with the shin parallel to the ground. The opposite hand is held by the side, and the same side hand is held straight out and above the head. Holding your head and all limbs off the ground, hold this position for a count of five, and then switch arms and legs, hold for a count of five, making one rep. Begin with 5 reps, and increase over time to 15, and/or hold the position longer.

9. Pointers
   
   Starting on your hands and knees, slowly lift and straighten one arm and the opposite leg. Hold this position for 5 seconds, return to starting position, and repeat with the opposite arm and leg. Do 5 on each side. The challenge is to keep your hips steady and parallel with the ground during the entire motion. Balancing a long stick on the middle of your lower back will not only help you feel that your hips are steady but will also increase the overall difficulty of the exercise.
   

These are just a few possible exercises, but they will make a big difference. I recommend doing them at least three days per week, and I often work them into my warmup routine before a workout. Begin with one set of each exercise, and gradually add reps and then sets to increase the workload.

See my recent post titled Thoughts on the Run #1; A Run Report and the Things That Bounce Around My Head While Doing It within which I discuss stride length and how to check it and correct it.

Join my 5k Training Program for all runners. Follow the training plan, post your workouts, and get ongoing guidance from me for 12 weeks!

About Coach Craig:

I am an avid running and coach. I have competed in every distance from 55 meters to iron distance triathlon, including a handful of marathons. As a masters athlete I focus on the 5K (masters pr of 19:40), 800 meters (2:12) and 400 meters (55.2), but I also run the Philadelphia Broad Street 10 miler every spring with my wife (1:16). I am not a fast distance runner, but partly because I am a sprinter at heart. I currently coach sprints at my local high school, and help my wife with her cross country team in the fall, as well as the winter track program at her school. I am also the vice president of Greater Philadelphia Track Club, the president of a youth track and field club that my wife and I started last summer, and hold a USA Track & Field level 1 certification. I have done extensive technique training and coaching, and attend two coaching conferences every year to keep up with the latest ideas. This summer I will be completing my USATF level 2 certification, most likely with a concentration in youth track and field.