• Luke Nelson

Does pelvic drop mean there is lateral hip weakness?

If your hips drop when you run, does it mean you have weak lateral hip muscles?


Also known as contralateral pelvic drop, or increased hip adduction, there has been some research linking this particular trait to running injury (Bramah 2018). Excessive pelvic drop is often seen in conjunction with a lateral trunk shift and/or excessive hip adduction.

The potential implications of this increased pelvic drop and increased hip adduction may include:

  • Lateral hip stress (gluteal tendinopathy)

  • Ischiofemoral impingement

  • Increased knee load (Nakagawa 2012)

  • Peak external knee adduction moment (KAM) & peak ankle eversion velocity were statistically greater in runners who sustained an injury (Dudley 2017)

  • Patellofemoral pain (Stefanyshyn 2006)

The increased pelvic drop is viewed from the frontal view during midstance. You can measure the angle by drawing a line through the PSIS and measuring the angle formed between this and a line parallel to the floor. Normal range here is less than 5 degrees. This is often associated with an increase in hip adduction and hip internal rotation which can be seen during midstance, looking for the “knee window” which is absent in this runner. You can also watch the popliteal fossa for any internal rotation.


Earlier research had suggested a relationship between contralateral pelvic drop and lateral hip weakness, but a recent study by Zeitoune et al found NO association with dynamic knee valgus to core endurance or posterolateral hip strength. This would also explain why strengthening the hip does NOT change hip drop/knee adduction, which has been the case in a number of studies (Ferber 2011, Snyder 2009, Earl 2011, Willy 2011, Wouters 2012, Brindle 2017).

So for those displaying pelvic drop, knee valgus or hip adduction (and it needs to be changed), running gait retraining is likely the best option here. With gait retraining, there are a number of different cues that can be used to create change, including:

  • Cue level pelvis: auditory, visual with video/mirror (Noehren 2011)

  • Cue knees apart

  • Increased cadence (Heiderscheit 2011)

So to reiterate, just because you possess pelvic drop during running, it does NOT mean there is hip abduction weakness, but also to the contrary, the absence of pelvic drop does NOT mean there is sufficient strength.


For assistance with your running technique or running injuries, please don't hesitate to contact us at www.healthhp.com.au

References

  • Bramah, C., et al. (2018). "Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?" Am J Sports Med: 363546518793657

  • Brindle, R. A. and C. E. Milner (2017). "Do Female Runners with Large Peak Hip Adduction Angles Lack Hip Strength and Control?" ACSM Annual meeting.

  • Dudley, R. I., et al. (2017). "A prospective comparison of lower extremity kinematics and kinetics between injured and non-injured collegiate cross country runners." Hum Mov Sci 52: 197-202.

  • Earl, J. E. and A. Z. Hoch (2011). "A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome." Am J Sports Med 39(1): 154-163.

  • Ferber, R., et al. (2011). "Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome." J Athl Train 46(2): 142-149.

  • Heiderscheit, B. C., et al. (2011). "Effects of step rate manipulation on joint mechanics during running." Med Sci Sports Exerc 43(2): 296-302.

  • Khayambashi, K., et al. (2016). "Hip Muscle Strength Predicts Noncontact Anterior Cruciate Ligament Injury in Male and Female Athletes: A Prospective Study." Am J Sports Med 44(2): 355-361.

  • Nakagawa, T. H., et al. (2012). "Frontal plane biomechanics in males and females with and without patellofemoral pain." Med Sci Sports Exerc 44(9): 1747-1755.

  • Noehren, B., et al. (2011). "The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome." British Journal of Sports Medicine 45(9): 691-696.

  • Snyder, K. R., et al. (2009). "Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running." Clin Biomech (Bristol, Avon) 24(1): 26-34.

  • Stefanyshyn, D. J., et al. (2006). "Knee angular impulse as a predictor of patellofemoral pain in runners." Am J Sports Med 34(11): 1844-1851.

  • Willy, R. W. and I. S. Davis (2011). "The effect of a hip-strengthening program on mechanics during running and during a single-leg squat." J Orthop Sports Phys Ther 41(9): 625-632.

  • Wouters, I., et al. (2012). "Effects of a movement training program on hip and knee joint frontal plane running mechanics." Int J Sports Phys Ther 7(6): 637-646.

  • Zeitoune, G., et al. (2020). "Do hip strength, flexibility and running biomechanics predict dynamic valgus in female recreational runners?" Gait & posture 79: 217-223.

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