Why balance can make or break a runner

Especially in the spring, it can feel as if it's a balancing act to train for upcoming races.

You're increasing your weekly mileage at the same time you're preparing healthy meals for your family and juggling deadlines at work.

Yet for runners, the idea of balance could not be more critical, because running is, after all, an actual balancing act.

"When you run, you never have both feet on the ground at the same time," said Ian Hankins, head men's cross-country and track and field coach at the Catholic University of America. "Everything needs to line up at the center of your body so you don't fall over. When your core and posterior chain are aligned and you're not tipping forward or leaning back, as a runner, you are more efficient and use less energy."

Runners who have an impaired sense of balance are at an increased risk of injury by tripping and falling, says physical therapist Kevin McGuinness, who practices at Washington Orthopaedics & Sports Medicine.

Imbalances also cause overuse injuries when certain muscles are forced to overcompensate for others.

So how do we know if we're off balance when we run?

Elite runner Tina Muir, who holds a half-marathon personal record of 1:13 and a marathon personal record of 2:41, found herself dealing with one injury after another, including hamstring strain, plantar fasciitis and calf strain, before she and her coach took a hard look at her running form.

"One of the biggest parts of being an elite is trying to figure out all the little things you can control to make yourself the best you can be," Muir said.

Muir had just done two marathons, and both had gone very badly, she said. "I really struggled around the usual spots where people struggle - or maybe even earlier - around 19 miles, and I just blew up, basically," she said.

"Looking at photos of myself, I could tell I was wasting energy," Muir said. "My upper body was moving side to side instead of forward, so most of my energy was pushing sideways instead of ahead."

Muir underwent a skeletal analysis of her gait at the University of Virginia SPEED Clinic, and it took six months of balance drills to retrain her body to run more efficiently and injury-free.

For Muir, that meant spending a few hours each week in the gym with her strength coach, Drew Watts, to correct the imbalances that she had developed running with poor mechanics over the previous 10 years.

A year later, Muir returned to the clinic for a follow-up analysis, and her gait had vastly improved. She said she has not suffered any running injuries since then.

Numerous factors can cause runners to be off balance, McGuinness said. Yet, as in Muir's experience, he said, deficits in any of the systems involved in running - poor motor patterns, inner ear or visual problems, or even core strength weakness - can be addressed by training.

Age, too, can be a factor affecting sense of balance, McGuinness said. Age-related changes to the visual and the vestibular system, in addition to muscle weakness and stiffness as we get older, can affect the brain's ability to make these kinds of adjustments as we run or, in some instances, walk, he said.

Inner-ear problems are common, he said, and side effects from medications as well as a decrease in brain tissue in the cerebellum, the part of the brain that helps coordinate movement, can affect a runner's sense of balance.

"Balance, like anything else, requires practice," McGuinness said.

"The good news is you can train the balance system by incorporating exercises that physically coordinate what the limbs are doing."

Balance exercises

All three of these exercises challenge your sense of balance in slightly different ways. Every drill combines muscular, skeletal, visual and vestibular input.

<span class="fact box text bold">Single-leg stance: </span>Stand on one leg in front of a mirror and place your hands on your hips. Keep your standing knee slightly bent and your hips level. Swaying a little is normal. Standing on a pillow or other soft surface makes this more difficult. See if you can hold this position for 30 seconds.

<span class="fact box text bold">Tandem stance:</span> Place one foot behind the other as if you were standing on a tight rope. Start with the back foot directly behind the front and increase the distance to make it more difficult. See if you can hold this position for 60 seconds.

<span class="fact box text bold">Farmer's walk:</span> Hold a moderately heavy weight in one hand and walk a pre-measured distance (try 50 feet to start). Maintain an upright posture and alternate arms after 50 feet.