If I were to name the most prevalent issue that I find in my athletes, it would be weakness throughout the hips and glutes. In American society, we very rarely squat or get below chair height when exercising. This, along with a distinct lack of strength training in runners, leads to poor gluteal strength and difficulty controlling the pelvis. When you have difficulty controlling your pelvis, the knee follows shortly behind, and does the ankle. So, you can experience pain in the low back, hip, hamstring, groin, knee, ankle, and foot. Some conditions associated with this are iliotibial band syndrome (ITBS), runner’s knee, patellar tendinitis/osis, posterior tibialis dysfunction, plantar fasciitis, and more.
Often you will see this described as “dead butt syndrome” or having glutes that are “shut off”. As a practitioner, I loathe these descriptions for several reasons:
- Your butt isn’t dead or off, it is just weak
- No muscle can be “shut off” without serious neurological injury
- This verbiage is negative and often leads to worse outcomes for patients because of a nocebo effect (negative talk = negative results!)
Semantics and verbiage aside, how can you identify hip drop in runners? Well, there are several ways. The most direct way of assessing this is to video yourself running from the front or back.
As you can see in this photo, during the middle of your running gait (what is called stance phase) you can see the hip dropping down on the opposite side. Now, it is unrealistic to expect someone to achieve a perfect 90 degrees and level pelvis, but we can certainly hope to get as close as possible. Unfortunately, (or fortunately depending on how you look at it) there is no magic threshold to cross before “hip drop” becomes a non-issue. It is different for everyone.
How about an indirect measure? If you are a runner who frequently scrapes, scuffs, or muddies the inner part of your lower legs, you should suspect hip drop. The reason for this is that as your hip drops, your knee and ankle move towards the one on the ground. Then, as your leg swings through, it has a tendency to just lightly clip the leg on the ground – leaving it scraped or muddied.