Why Doesn't Good Technique Prevent Injury?

If you believe that moving with good technique will protect you from getting injured, the results of a recent study will SHOCK you!

Most exercise prehab and rehab programmes take either a:

• "Top-down" approach = strengthen hip and core
• "Bottom up" approach = strengthen foot and ankle

A 2024 study followed 325 novice runners with an average of 40 years, over a 24 week training programme. The runners were split into 3 groups who did one of the below physio-led interventions before running:

• Static stretching (control group)
• Hip and core exercises 
• Foot and ankle exercises

The hip and core group had fewer overuse injuries compared to the other two. 

HOWEVER, 42% of the hip and core group still suffered at least 1 overuse injury (compared to 54% in the control group), and at least two thirds of these injuries were substantial. 

What this finding reveals is....

• The role of the foot / ankle and pelvis / hip / lumbar spine in movement and injury prevention CAN'T be separated. They work together symbiotically, and need to be addressed as such.
• Even doing exercises correctly whilst being supervised by a physiotherapist is NOT enough to stop you hurting yourself. Therefore, good technique isn't the holy grail of injury prevention.

What were the other results from this fascinating, and possibly controversial, research study?

• Over the 24 week programme, the 325 runners reported 310 running-related injuries
• Of these, 91% involved the lower leg, and 87% were classified as 'overuse' injuries
• Doing hip and core exercises before running didn't help reduce acute lower leg injuries.
• The foot and ankle group had a higher incidence of acute lower leg injuries, compared to the other 2 groups
• The highest percentage of overuse and substantial overuse injuries was seen in the control group doing static stretching before running
• The more hours the runners racked up, the fewer remained injury-free, At 60 hours of recorded running, less than 40% of the hip and core group remained injury-free, and only 20% of the other 2 groups reported zero injuries.

How Can You Use These Results To Stay Injury and Pain Free?

1) Address the foot / ankle and the hip / pelvis / lumbar spine together

I was taught to focus on correcting the hip and pelvis first, as these were bigger structures with more influence on how the body moves than the feet.

Now, experience is showing me that the whole "top down" versus "bottom up" approach is flawed, and that you can't say one is more important than the other.

I believe that they actually have a symbiotic or collaborative relationship, and that both need to be considered at the same time.

From the above diagram you can see how the pelvis balances on the head of the femur (thigh bone) at the hip joint.

The hip joint is ultimately stabilised by the foot, and how it engages with the ground.

If the pelvis isn't centred and balanced on the hip joints, it'll change foot balance and function.

A wobbly, unstable foot will lead to a wobbly, unstable knee, which will lead to a wobbly, unstable hip joint, and ultimately a wobbly, unstable pelvis.

Therefore, it's more realistic and effective to examine the relationship between the foot / ankle, and hip / pelvis, rather than strengthening one of the other.

2) Good technique is NOT the holy grail of injury prevention

All 3 test groups in the study did their prescribed exercises supervised by a physiotherapist. Therefore, I think it's reasonable to assume that their technique was being corrected.

However, this still didn't prevent substantial overuse injuries from happening to at least 40% of the runners.

Technique is prescriptive, and ignores individual differences in HOW people move. 

There are many other factors to consider when assessing movement, such as:

• Brain and nervous system 
• Learned behaviours, eg. aversion / avoidance / fear / catastrophising / pain
• Adaptions and mal-adaptations
• Joint velocity (direction and speed)
• Injury and medical history
• Previous life experiences

Sticking to text book technique may actually destabilise your body and increase stiffness, as one of my class members discovered during a recent 1:1 session.

He'd been getting increasingly frustrated at his lack of progress with the stretches and lunges prescribed by his physio. When we changed his foot alignment away from what would be considered correct, he suddenly felt his body stop fighting him, and his muscles visibly went "Phew!!!!!!".

You see, text book technique didn't take into account that the anatomy of his ankle joint had been altered by major surgery after a serious road traffic accident. 

The joint velocity of his left foot, ankle, knee and hip were massively improved when he turned his foot slightly outwards. He instantly felt less wobbly and stiff.

Even better, his pelvis, which had been twisted and tilted with one hip higher than the other, then corrected itself. The benefit of this will be less pressure on his right hip, which has started to develop a painful bursitis as a result of this imbalance. 

He's now going to revisit his physio exercises with this new awareness and fresh enthusiasm at the significant progress already made after just a single 20 mins 1:1 session. 

WAYS TO WORK WITH ME

The Befriend Your Body Method for Pain Management & Relaxation community class

Next date: Sunday 18th August, 1.30pm to 3pm (just 6x spaces left). Book HERE

A small group, tranquil mindful movement class for pain management and relaxation, with a deeply soothing sound bath meditation.

During the class, you'll learn how to use small movements to successfully rebalance your body, release muscle tension and reduce pain. 

Then immerse yourself in the calming sounds and healing vibrations of the crystal singing bowls, ocean drum and rain stick. You'll leave feeling fully rested, deeply relaxed and rejuvenated. 

This class is for you whether you're looking for a natural way to manage pain with a mindful movement practice, or simply to quietly rest in a peaceful sanctuary.

Click HERE for all the details, including how to book. Numbers are limited to a small group to nurture a friendly, inclusive and supportive community for all members.

Other ways you can find help with managing pain or an injury are:

• Book into a Stretch or Pilates class with me - these are a good introduction to the movement explorations of The Befriend Your Body (BYB) Method  for pain management and relaxation.
• Apply HERE for an Unlock Your Body breakthrough session. This is a single 1:1 focused session designed to help you find simple solutions to a persistent or recurring injury. You'll leave with a deeper understanding of what's triggering pain in your body, and a clear plan of action to get lasting relief. 
• Get your copy of my free E-guide "How to Get Relief From Back Pain and Muscle Tension in just 10 mins a Day". This introduces the 3x universal stress responses that can keep you stuck in pain, and explains the 4x pillars of The BYB Method. There's also 2x 10 mins video tutorials showing you how to release muscle tension from the front and back of your body in the comfort of your without expensive equipment. Download for instant access HERE
• Subscribe HERE to receive "The Movement Chronicle", a weekly e-newsletter delivering mobility and pain reduction tips directly into your inbox every Monday morning,

You can connect with me through any of these channels:

• Email at norma@unicornhealthandfitness.com
• Follow me on Facebook and DM me on Messenger https://www.facebook.com/norma.pearsonfitness
• WhatsApp message to 07801 867361.