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3 main goals (+ running) Injury Prevention Biomechanical inefficiencies from the core down (running style, pelvic tilt, knee tracking, hip control, weight distribution, weak or inhibited muscles, etc.) Strengthening all key muscles (leveling out all muscle imbalances, etc.) Treating and preventing tight muscles When setting up your list of questions, you should sort your questions under two clear titles: Practical Assessment, and Questions. “Preventing every running-related injury” – research all the important running injuries and how to prevent them. The real solution to fix this is achieving the ideal biomechanics of the athlete (e.g. active glutes, no pelvic tilt, correct running style) Causes Misalignment of the pelvic joints more properly known as the sacroiliac joints is the primary culprit for buttock pain. Altered relationships between the tailbone (sacrum) and the pelvis (illium) in the body cause increased pressure and strain as well as loss of motion in the sacroiliac joints. Many patients mistakenly state, "My hip hurts" when in fact, it is the sacroiliac joint that becomes misaligned. These gliding joints are found in the pelvis and their function is to allow for movement and flexibility of the spine. When these gliding joints (facet joints) are affected by repeated trauma from excessive strenuous athletic activities, heredity, weakened or de-conditioned muscles, and the inevitable aging process, low back, buttock and/or leg pain is commonly experienced. Contributing factors to the development of trochanteric bursitis There are several factors which can predispose patients to developing this condition. These need to be assessed and corrected with direction from a physiotherapist. Some of these factors include: • joint stiffness (particularly the hip) • muscle tightness (particularly the gluteals) • muscle weakness (especially the hamstrings and gluteals) • poor biomechanics • inappropriate or excessive training • inadequate warm up • inadequate rehabilitation following a previous buttock or hip injury • poor pelvic or core stability • neural tightness • leg length discrepancy Trochanteric bursitis is now referred to more generally as greater trochanteric pain syndrome, since bursitis is considered an uncommon cause. The head is the ball and socket joint connected to the pelvis. A bursa is a fluid-filled sac that provides cushioning between bones and tendons and/or between bones and muscles around a joint. Bursae are filled with synovial fluid and are found around most major joints of the body. The most common site of bursitis is the shoulder. However, bursitis is not limited to the shoulder. All joints and areas where there is movement have bursae. Therefore, it is possible to develop bursitis in areas all over the body. Where there is a joint, there are bursae. Around a joint, When healthy, a bursa creates hundreds of smooth and almost frictionless surface over which these elements slide. This is why most movements are painless. The trochanters are points at which hip and thigh muscles attach. The greater trochanter gives attachment to a number of muscles (including the gluteus medius and minimus, piriformis, obturator internus and externus, and gemelli muscles), and the lesser trochanter receives the insertion of several muscles (including the psoas major and iliacus muscles). The trochanters are bony prominences in the femur (in layman’s terms, the hip region). There are two trochanters, the greater trochanter and the lesser trochanter. Most of the time the "bump" you feel on the outside of your hip/upper leg is the Greater Trochanter. As with most "bumps' on bones, the trochanters serves as anchor attachments for the muscles in hip/leg/buttock area. So to recap, trochanters exclusively refer to bumps on the femur bone. Bursae are sacs covering joints, between muscle/tendon and bone, not exclusive to the hip region, but in all joints around the body producing movement. Bursitis is the inflammation of one of more bursae in the body. tendons at the hip hip pain whilst walking Remember hip pain doesn’t have to be trochanteric bursitis. Other possibilities include: arthritis, osteonecrosis (degenerative blood supply to the bone), a muscle strain, stress fracture, hip labral tear, hip snapping syndrome, dislocated hip, lower back problem, tendinitis. The most common injuries of the hip and groin region in athletes are muscle strain injuries. Muscles around the hip joint are especially prone to this type of injury because they are subject to eccentric contraction. Eccentric contractions cause tremendous forces in the muscle and can lead to a muscle strain. Muscle strains around the hip include groin pulls and hamstring strains. The labrum is a ring of cartilage that surrounds ball and socket joints (i.e. shoulders and hip). It helps to provide stability to the joint by deepening the socket, yet unlike bone, it also allows flexibility and motion. A degenerative tear is a chronic injury that occurs as a result of repetitive use and activity. Degenerative labral tears can be seen in the early stages of hip arthritis. A traumatic hip labral tear is usually an acute injury as a result of a sports injury, fall, or accident. Hip labral tears can be seen in association with episodes of hip dislocation or subluxation. They are commonly associated with sudden, twisting maneuvers that cause immediate pain in the hip. Typical symptoms of a hip labral tear include: groin pain, clicking and snapping sensations in the hip and Limited motion of the hip joint. Hip snapping syndrome: an audible snapping or popping noise as the tendon at the hip flexor crease moves from flexion (knee toward waist) to extension (knee down and hip joint straightened). While not a problem of the hip region, low back problems can often cause pain around the buttock and hips. ITBS symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. Pain may also be present above and below the knee, where the ITB actually attaches to the tibia. ITBS can also occur where the IT band connects to the hip, though this is less likely as a sports injury. It commonly occurs during pregnancy, as the connective tissues loosen and the woman gains weight—each process adding more pressure. ITBS at the hip also commonly affects the elderly. ITBS at the hip is studied less; few treatments are generally known, This may also happen when a child's or teenager's hip grows faster than the band, and it creates tightness over the hip and knee, therefore creating a popping and snapping over the hip or knee. The hip is made up of THREE separate bones: the pubic bone, the bowl of the hips, and the crest. What causes constant cracking of the hips? It could be tendon rubbing against the bone, or it could be the cartilage between the femur bone and the hip socket that is popping. http://my.clevelandclinic.org/disorders/bursitis/hic_trochanteric_bursitis.aspx http://en.wikipedia.org/wiki/Greater_trochanteric_pain_syndrome The concern is only fixed when I can exercise without injury. All common biomechanical inefficiencies - overpronation - oversupination - increased Q angle - hip hiking – lifting the hip to one side - ankle equinus – limited ankle dorsiflexion (less than 10 degrees) - pelvic tilt – anterior, posterior or lateral The human body and how it moves in mechanical terms can be divided into two areas of study: 'extrinsic' and 'intrinsic' biomechanics. Extrinsic Biomechanics looks at movements and the measurement of those movements, then establishes the most efficient way to perform them. It is an important science that is relevant to any sport, fitness or physical conditioning programme. Intrinsic Biomechanics, on the other hand, is the study of how the body is able to perform those tasks or movements in relation to the individual's mechanical make-up.