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Lily Canter

If you are new to running, and in training for any of the coming running races in Hong Kong, you will want to know this: a top-down approach to strength training could be the key to reducing injury risk for novice runners.
A study of 325 beginner runners found strengthening hips and core was the most effective way to reduce injury when compared with strengthening ankle and foot muscles or doing static stretches.
The 245 female and 80 male athletes underwent a 24-week study in Finland where the different exercises were put to the test. The adult novice runners, whose average age was 40, were split into three groups.
Researchers wanted to know whether a top-down or a bottom-up strengthening programme was best. The top-down approach focuses on building muscles around the hips and core (lower back, pelvis and stomach).

The idea behind this is to reduce joint movement in the lower limbs when running, which helps to decrease the risk of injury.
Another theory, called a bottom-up approach, advocates strengthening the small muscles crossing the ankle joint, to reduce forces through the ankle, knee and hip joints.
In the study, each group undertook a 30-minute intervention session before a 30-to-75-minute run, twice a week. The hip and core, ankle and foot, and static stretching groups all completed eight exercises each, led by a physiotherapist.
The study concluded the hip- and core-focused exercise programme, when compared with static stretching, was “effective in preventing lower extremity overuse injuries in novice recreational runners”.

By comparison, the ankle- and foot-focused programme was “not effective in reducing injuries in novice recreational runners”.
The hip-core group had a 39 per cent lower rate of injury than the control group (static stretching) and a 52 per cent lower rate of overuse injury. The foot-ankle group were more prone to injury than the control group.
Although there has been much research into injury prevention in team sports, few studies have been carried out with novice runners, said lead author Dr Mari Leppänen, of the Tampere Research Centre of Sports Medicine in Finland.
“We know that many runners quit running due to injuries; this is the case especially among novice runners who are at increased risk of running-related injuries (RRIs) compared to more experienced runners.
“We wanted to examine how RRIs could be prevented to support long-lasting recreational running and physical activity in adults,” she added.
The results, published in the British Journal of Sports Medicine, mirrored findings found in team sports but also threw up some surprises.

Static stretching was used as a control in the study because previous research has suggested it is mostly ineffective in sports-injury prevention.
“What was a little surprising was that the ankle- and-foot-focused training did not prevent RRIs when compared to static stretching,” says Leppänen.
“Another interesting finding was that stretching appeared to be effective to reduce the risk of acute running injuries such as muscle strains occurring in high-speed or uphill running.”
This finding should be taken with caution, she suggests, and should be confirmed in future studies.
The researchers also noted acute injuries were significantly higher in the ankle-and-foot group compared with the control group.

The researchers concluded that, to reduce the risk of injury, runners should incorporate into their weekly schedule hip and core strengthening exercises. These include:

lunges


pelvic lifts


hamstring curls


hip abductors (such as standing with your back straight and feet facing forward, moving your right leg out to the right side until you feel strain along the outer side of your hip and leg, bringing the leg back to standing, doing 12 to 15 repetitions, and then doing the same with the left leg)


hip flexors (such as a knee to chest stretch or bridge); and


planks.

Search online for YouTube videos of these exercises to see demonstrations.


“Training can be done with limited equipment at home by using minibands, or you can do the workout at the gym. Two to three times a week, 15 to 20 minutes at a time, is enough to reduce the risk of running-related injuries,” advises Leppänen.
“Remember to vary exercises and progress with repetitions, sets and loading as you get stronger.”

Cardeux Nel, a sports physiotherapist at the Hong Kong Foot Clinic and a trail runner, also advocates building hip and core stability to reduce injury.
She treats many athletes suffering with common running overuse injuries such as iliotibial band syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis.

Nel also recommends exercises such as crab walks, side planks, bilateral and single-leg bridges and progressive squats.
“The top-down approach begins with ensuring that the core and hips provide a stable base for the rest of the body’s movements,” Nel says.

“These exercises are integral to this approach, as they activate and strengthen the glutes, hip abductors, adductors, and core stabilisers, creating a stable foundation for efficient movement.”
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How to avoid running injuries for beginners? Stronger hips and core are key, study finds

An injured runner stops during the Standard Chartered Hong Kong Marathon in 2018. A study in Finland has found that strengthening the hips and core before exercising could be the key to reducing injury risk for people new to running. Photo: Dickson Lee

Racers take part in the Standard Chartered Hong Kong Marathon in 2024. Photo: Elson Li

Performing hip- and core-strengthening exercises two to three times a week for 15 to 20 minutes at a time will reduce the risk of running-related injuries, says Dr Mari Leppänen (above). Photo: Tampere Research Centre of Sports Medicine

Use a miniband for dynamic hip flexion exercises like this one. Photo: Tampere Research Centre of Sports Medicine 

Single leg pelvic lifts are good for strengthening hips and core. Photo: Tampere Research Centre of Sports Medicine 

A personal trainer demonstrates a lunge. Photo: May Tse

A woman performs a straight-arm plank exercise with legs raised. Photo: Shutterstock

A lying hamstring curl can be performed in a gym using a machine. Photo: Shutterstock Images

Cardeux Nel, a physiotherapist and trail runner, recommends exercises such as crab walks, side planks, bilateral and single-leg bridges and progressive squats. Photo: Cardeux Nel

Crab walking is recommended to help strengthen the core and hips, so they can provide a stable base for the rest of the body’s movements. Photo: Shutterstock

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Lifestyle

Health & Wellness

Health

A study in Finland found that strengthening the hips and core before exercising could be the key to reducing injury risk for newbie runners


A study in Finland found that strengthening the hips and core before exercising could be the key to reducing injury risk for newbie runners.


How to age well

Health & Fitness