Prevent Running Injuries: Inefficient Movement Patterns and the FMS

by Jason Fitzgerald

Runners are always looking for the newest way to prevent running injuries and help them train smarter. From compression socks, foam rollers, and even full leg compression sleeves (ridiculous, aren’t they?).

Most of the products that you buy help you recover from hard training or treat running injuries. But I had an opportunity recently to diagnose my personal movement inefficiencies, inflexibilities, and weaknesses to prevent injuries from happening in the first place. Who needs to recover if you’re not that beat up from training in the first place?

Last week I went to the Maryland Sports Injury Center to receive a Functional Movement Screen, which identifies muscle strength and flexibility limitations. I’m a firm believer that the majority of running injuries can be prevented by not pushing the body to do too much, too soon, and by consistently incorporating strength and flexibility exercises in your training.

Since about April of 2009, I’ve been free of any major injury and ran the most I ever have in 2010 (a bit over 3,000 miles). So, I think I’m doing most things right with my training. I know I have some limitations – everybody does – but I was curious to see what an expert could learn from studying my own movements and what it can teach you.

I met with Jason Schrieber, a Certified Strength and Conditioning Specialist, a USA Weightlifting Club Coach, and HKC Kettlebell Instructor. He has a BS in Kinesiology, competed in mixed martial arts and powerlifting, and has taught Anatomy and Physiology, Health and Exercise Science, and Physical Education.

It was important to me to meet with someone who was not a runner but who’s had experience with runners. I wanted brutal honesty about my physical imbalances. I’ll see a different professional for my mental imbalances.

The Functional Movement Screen

We got down to business quickly and started the FMS, which is a series of 7 exercises and 3 simple movements to test for pain. They include:

  • Deep Squat
  • In-Line Lunge
  • Shoulder Mobility
  • Impingement Clearing Test
  • Active Straight Leg Raise (ASLR)
  • Trunk Stability Push Up
  • Press Up Clearing Test
  • Rotary Stability
  • Posterior Rocking Clearing Test

Each exercises is scored on a scale of 0-3, with 3 being perfect and 0 being a complete fail. The three movements to test pain are a simple pass/fail and include the impingement clearing test, press up clearing test, and posterior rocking clearing test. Most of the exercises are detailed in the video below.

As I went through each exercises, I became more and more confident that the numerous strength and core routines that I do on a regular basis have helped me become a better athlete. While each movement was different than what I routinely do after my training runs, they were similar enough that none of them were particularly difficult.

Now I want to go through and briefly describe each exercise, how I performed, and its importance to runners. I’ll stick to the actual exercises and leave out the three pain tests.

The deep squat is performed with a light bar held above your head. A perfect score is given if you can keep the bar above your head without it moving toward the front of your body and you can lower your thighs beyond parallel. I scored a 2 out of 3 in this exercise because the bar moved in front of me slightly. This is probably due to shoulder instability.

It’s important for runners to be able to go through a proper squat movement. If that movement is impossible, your hips and hamstrings are very tight and your stride mechanics are likely inefficient. I consider this exercise to be one of the most important and most predictive of running injuries.

The in-line lunge is essentially a split lunge with both feet pointing forward along one straight line. You hold a bar behind your back to keep your torso in line. You need to have great balance and leg strength to be able to do this movement without falling over. Lacking the coordination to do a simple lunge is problematic when you consider running is a series of one legged hops. I scored a 3 on this exercise.

Prevent Running Injuries - FMS Evaluation

Fitz's FMS Evaluation

The shoulder mobility exercise was done by putting your arms out to your sides and then twisting them behind you in opposite directions to have them touch between your shoulder blades. While I scored a 3 on this exercise, it was evident my right shoulder is tighter than my left – probably from spending too much time at a computer. This exercise is not as specific to running as the others.

Next was the active straight leg raise. This was a simple hamstring flexibility exercise where I laid on the floor and kept my left leg still while I raised my right. I fared poorly on this test and scored a meager 1 – my lowest score of the day. I’ve had minor hamstring issues in the past, but never anything serious. A score of 1 isn’t good though, so I’ll be working on increasing my hamstring flexibility.

The trunk stability pushup was the hardest exercise in the set. It was essentially a standard pushup except your hands are planted well in front of your shoulders. It requires a lot of core activation and stability to not let your stomach sag below your shoulders and knees. I scored a 3 on this exercise, but I think Jason was being lenient on me.

Finally, the rotary stability exercise tested balance and stability in the shoulder. It’s essentially a bird dog exercise and is featured prominently in the video above. You raise one arm in front of you while lifting the opposite leg behind you and then bring your knee to your elbow underneath your torso.

The only way you can score a 3 is if you can do this exercise with your leg and arm on the same side. I tried a few times and fell over each time. It wasn’t pretty, so I scored a 2. Jason said that he’s only seen one person ever score a 3 so I felt a little better about myself.

FMS Lessons on How to Prevent Running Injuries

The test was fun but more importantly, it gave me some actionable lessons that I can use in my training help prevent running injuries. First and foremost is my lack of hamstring flexibility. My long runs before the New York Marathon were 16 miles and then another 6 on the track at sub-6 minute pace. Remembering back on those workouts, my hamstrings failed first.

I learned several new active stretches to do for my hamstrings, which I’ll hopefully detail in a future video.

There’s also a clear tightness in my right side as opposed to my left. Again, this is probably because I spend too much time in front of a computer. I learned a great shoulder stretch to use and I need to be more aware of my posture while typing. These are good lessons for anyone and things I knew before heading in for the FMS. But seeing the results of poor posture in limited movement patterns really wakes you up to making change in your day to day life.

The FMS is something I’d recommend to any runner who’s curious about their imbalances, inefficiencies, inflexibilities, and poor movement patterns. My one criticism is that it’s not entirely specific to running. I’d love to see a running-specific FMS developed to evaluate the running stride and movement of runners (something a bit less involved and costly than Jay Dicharry’s sports lab).

I want to thank Jason for his help, guidance, and expertise during my time at the Maryland Sports Injury Center. He was very thorough going over each exercise and never once made fun of my running shorts. I came away from the Functional Movement Screen knowing more about my body’s limitations and imbalances – knowledge that I know will help me become a better runner. If you live in the greater DC area, definitely check them out.

Congrats to Steve T. for guessing my biggest inflexibility! I’ll think of a cool prize and get back to you.

Full disclosure: the FMS was complimentary in exchange for a review.

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Greg Strosaker

Thanks for the summary Fitz, looking forward to you posting your score on your mental imbalances. Seriously though, I imagine the hamstring is the issue for most runners, it will be interesting to see you apply your ITBS rigor to improving your hamstring flexibility. I was not surprised when my hamstring failed me first – it has gone out at mile 25 in all 3 of my BQ marathons, specifically the left side which is where my current injury is. I can’t see the video at work, but I’m curious as to how accurately a runner can self-assess using these techniques?

Finally, I am firmly in agreement with your point that often it is better NOT to be assessed by a runner – I think both my PT and chiropractor have misinterpreted my priorities in recovery based on their own biases, and advocated running sooner than I should have. The contrary voice is sometimes (maybe often) needed in such situations, at the least to get a breadth of opinions.

Fitz

Self-assessment would be difficult, as you’d have to rely on guesswork to get the movement correct. And I bet you need experience to be confident in your ability to score each movement on a 0-3 scale. Nevertheless, I think there’s some value in doing it yourself. But it doesn’t match up to having a professional grade you (and at the cost of a pair of shoes, it’s quality preventative care and well-worth it in my opinion).

Steve

I look forward to seeing a video on the active flexibility exercises for the hamstrings. I have had tight hamstrings as long as I can remember. I have tried quite a variety of exercises, but none of them have seemed particularly effective.

Presently, I abandoned the static hamstring stretches pre-run and do some active leg swings and toy soldier (straight leg kicks) to get them loosened up pre-run. After the run, I do some downward facing dog and traditional bend at the hip stretches.

I have tried hamstring stretch along a door frame (from the lying down position) including pushing on the door frame then increasing the amount of stretch. I did this diligently for 4 months but never saw an appreciable improvement in my hamstring flexibility. We’ll see if the active exercises they showed you can help in my situation.

Thanks for sharing your FMS experience.

Steve

Fitz

Thanks Steve! The resistance stretching you did against a door is similar to what I was shown (just without the door frame). Some people are naturally tighter, but it’s not necessarily a bad thing. See here: http://running.competitor.com/2011/01/training/want-to-improve-your-economy-stop-stretching_21094

Armi Legge

Great work Fitz:D

I think another great way to assess functional movement is through…Movement!

While I definitely agree that a FMS is much more in depth and comprehensive than just running, I do think that you can learn a lot by just paying attention to what parts of your body begin to fatigue and stay tight.

Another important thing to remember is that a lot of imbalances are caused by our lifestyles. Things like excessive sitting, sleeping at odd angles, and even using a pillow can all cause imbalances to occur.

I think stretching is definitely overrated, and I tend to lean more towards things like Kelly Starrett’s Mobility WOD’s for improving functional movement.
http://www.mobilitywod.com/

Excellent job man!

-Armi

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