Hi guys! This video is for people who's got gluteal tendinopathy and who want to get
back to running. So, what I'm going to do is, I'm first just going to touch base on what happens,
why do you get gluteal tendinopathy, what other treatments may be useful, and then I'm going
to talk about things you may want to change to your running style that could have contributed
to your glutes over-straining. So, my name is Maryke. I am one of the physiotherapists from
sports-injury-physio.com, where you can get online physiotherapy assessment as well as treatment for
your injuries. Have a look at the description of this video if you would like more information
about that. Okay, so gluteal tendinopathy can give you pain deep inside your buttock or over the side
of your hip sometimes, and it basically happens when you've done exercise that over-strained the
glute muscles’ tendons. So, the glutes attach into a tendon, attaches onto the bone. Now,
things that can cause that is if you suddenly increased your load-bearing activity. So, for
instance, you’re used to walking, lots of walking, but then you start to run every second day,
and all of a sudden it goes, “Oh no no no! I'm not used to this high load of exercise!” For women,
often it can also go hand-in-hand with when the menopause starts, because that can affect how
quickly your tendons recover. But I've spoken about all of this in detail in another video;
have a look – I'll link to this video … to that video at the end of this one. So, the things in
your running style specifically that can cause the glute tendon to over-strain is if you over-stride.
So, that's when you place … or make contact with the ground quite far in front of your body; and
you’re usually a heel-striker if you over-stride. So, what happens is, by placing your foot in front
of you, you kind of create a braking force. So that increases the forces up through the hip,
and that can cause the tendon to over-strain. I'll demonstrate it in a minute. Then, if you run and
you get a pelvic drop. So, you don't control your pelvis very well, and that can go in hand with
lacking the strength in your glutes and pelvic stability muscles. So, it's important to look that
you get good muscle strength before you go back to running. Let me demonstrate that while I'm talking
about it, because it's much easier to picture it then. So, if you think of the over-stride:
That would be if you make contact with the ground in front of you. So, you can see that's going to
create a small braking force through me, through my body. Now, the pelvic drop I'm talking about
is, if you look at yourself running on a video, and you see that happening, your pelvis dropping
as you run. So, if you support it on one leg, that type of thing. Because this glute tendon
will then over-strain. Then also, if the legs move in excessively when you run. So, that would cause
a strain on it. So, a lot of people tend to run with quite a narrow gait, as if they're running
on a tightrope, and that can cause trouble in the glutes. Then, the last one is if your knee
turns in excessively when you place it down, that can cause strain on the tendon. So, how do we fix
it? We just try and reverse all of those things. So, a few strategies that can work is if we try to
reduce the impact forces through the legs. So, the first thing you can do there is try and increase
your cadence. So, that's how quickly you step, or how many steps you give in a minute. So, first of
all, you have to count how many you give in a minute to know if you need to increase it. You
can either do that looking at your watch or you can literally just count and time for a minute,
but ... Like, my watch tells me how many steps I give in a minute. And when you try to increase it,
don't try and increase it by a lot, because that's too difficult; just go for 5%, so, a few steps
more. That's been shown to help with ... That can help to decrease how much your pelvis drops
because you've got less time that you spend on the ground. It can also decrease the impact forces
through there through reducing your stride length. So, if you're giving quicker steps, you tend to
not over-stride so much. Something else that can help with over-striding is if you think about
trying to land with your foot underneath your centre of gravity or your body. So for instance,
if you're running, you lean forwards from the trunk and you try to make contact as you land,
closer in. So, you're not landing out there, you try and land more there, and you'll find that that
naturally tends to put you into more of a mid-foot kind of strike rather than a heavy heel-strike.
Other things that could help is if you think about running softly. So, listen to your steps. Do you
sound like an elephant, boof boof boof, really hard heel-striking? Then try to soften that,
because by just trying to soften that, it often increases your step rate and it decreases how
much force goes through your body. For the knees turning in excessively: Simple cue that works for
me, because when I get tired towards the end of a run, I definitely, “Oh, I look terrible!” ... You
know those pictures they always take at the end of a race, where you come over the line,
you feel like a hero, and you look at it and you've got the worst style ever? So, yeah,
my legs definitely collapse towards the end of a race. But if I tend to just think about trying
to keep my knees pointing forwards while I run, that tends to help it that it doesn't quite turn
so much. So, what I tend to do ... So, you can feel when you land, your leg kind of does that;
you want to just slow it down, that you maybe just get that. Don't overdo it that you end up running
with your knees pointing out, it's just gotta be forwards, or slight in and come back, but not
excessively in. If you're one of those people who have quite a narrow line of progression,
tell-tale sign is if you kick yourself … You know when you finish your run and you've got loads of
mud there? Again, something I do. Then you can maybe concentrate on just not quite placing your
feet on such a tightrope, okay. So, just try and space your feet a little bit further apart
when you run. It's really difficult to change your running style, so the best way to do it … because
it's something that's ingrained in you, you do it automatically; and you've now got to replace an
old programme with a new one. So, the best way to do that is to do through run-walks. But if you're
coming back from gluteal tendinopathy, you should in any case be doing run-walks; you shouldn't
be doing continuous running, because you're more likely to really reinjure yourself if you go back
into continuous running immediately. Now ... So, use that period where you're coming back to it to
slowly use run-walks to practice your running style. So, think … Do one minute's running,
but think about, “Where are my legs moving?” then walk again, one minute running, think
about landing closer underneath you, and walk again, so that, before you get tired … because
if you’re tired, you'll lose your form in any case because your muscles will just go,
"Ehh! Can't do this anymore!" So, practice it in those little bursts, and you're much more likely
to be able to get it to become automatic. It takes roughly three months of thinking
about something before it becomes automatic, or that's for myself, in any case. Excellent! Let
me know if you've got any questions. And if you need more help with your injury, you're always
welcome to consult us via video call – link is in the description of this video. Take care!