So last week we introduced the subject of ‘lordosis’ or ‘anterior pelvic tilt’ and how it impacts upon runners and triathletes. In the blog I stated that from my experience, athletes with lordosis or anterior tilt are at high risk of suffering the following injuries or problems:

1. Lower back pain (pretty much always a link between lower back pain and anterior tilt of the pelvis).
2. Constant tightness in the hamstrings (certainly can’t touch your toes!).
3. Possible pain or tightness in the front of the hip/groin area.
4. Potential cramp or spasm in the quads (front of your thighs), more common running downhill.
5. Running ‘stitch’ (bearing in mind that a stitch is a word used to describe and pain in the abdominal region when running!!).
6. Problems breathing (can’t breathe deep and have to breathe rapid and shallow), sometimes but not always coupled with stitch.
7. For triathletes, these problems are worse when running after cycling (when running immediately after cycling your hamstrings are tight, get quad cramps and breathing difficulties or stitches).

The aim of today’s blog is to explain the potential reason why each of the above happen, linked to lordosis posture.

Some basic things to understand:

In last week’s blog we discussed that the pelvis can tilt forwards or backwards, dictated by which muscles are pulling and in which direction. The 4 muscle groups we discussed were:

1. Core abdominals
2. Lower back
3. Hamstrings (rear of thigh – including glutes)
4. Hip flexors (front of thigh / hip)

when you have lordosis posture we said that the hamstrings and hip flexors are tight, as are the lower back muscles. The core abdominals are generally weak.

Why are muscles tight?

It’s important to understand why muscles are tight, as there is more than just one reason. If you stretch a muscle and make it longer, you will inevitably make it tighter. It’s simple to understand, imagine a muscle is like an elastic band. Pull the elastic band and lengthen it, it gets tighter. However, muscles can become tight because then are shortened, NOT lengthened. Initially this doesn’t make sense, think about the elasatic band, if you stop pulling it and allow it to shorten, then it relaxes. Generally muscles will get tighter when stretched and lengthened and relax when shortened, but not in every case.

Shorter and tighter

Imagine if you put your leg in a plaster cast for 6 months with your knee bent at 90 degrees. When you bend your knee, this shortens the hamstring. When the day finally arrives to have the cast cut off, it’s unlikely that you will be able to straighten your leg. The reason for this is that the hamstring muscle has spent so long in a shortened position, it’s now stuck at that length! Here’s the critical thing, if muscles spend a long time in a shortened position, they eventually get used to that length and it becomes relatively permanent. The irony is that they were initially shortened, which made them relax. They got used to that shortened position, adjusted in length and eventually that makes them feel tight!!

Confused?

Let’s simplify this, some muscles get ‘stretched’ which makes them feel tight and some muscles get ‘shortened’ which makes them feel tight. It just depends on whether you lengthen it (stretch it) or shorten it (and leave it shortened for a long period of time). Check out our image which we used last week, here’s what happens to our 4 muscle groups:

1. Hamstrings get pulled upwards (stretched) and this makes them feel tight.
2. The hip flexors are shortened and over time they adjust in length (feel tight)
3. The lower back muscles shorten and over time they adjust in length (feel tight)
4. The abdominals are stretched (you won’t feel this like stretched hamstrings)

Why am I getting the symptoms you’ve written above?

Ok, so at the start of this blog I listed the possible symptoms of lordosis. I think the 4 points directly above explain the reason for lower back pain, tight hamstrings and tightness in the front of the hip / groin area. Let’s just take a closer look at the lower back pain. How does the lower back pain feel? Does it feel tight (like a tight hamstring) or is it more of a sharp, disabling ‘spasm’?

Spasm or cramp?

We’re going off into weird territory now, but this is a really worthwhile discussion. When a muscle contracts very sharply (often painfully), we refer to this as a ‘spasm’ or sometimes we call it a ‘cramp’. They may sound different to you, but we tend to use the words interchangeably for the same thing, largely because we’re confused and really don’t fully understand what’s going on.

When people get cramp in running races, generally they are in a state of fatigue and often they blame a lack of salts. It’s unlikely that loss of salt is causing cramp, but that’s a whole scientific discussion we’re not going to have in this blog. Back to the point, when people are knackered, they start to cramp. Whether it’s 22 miles into the marathon, 95 miles into a bike ride, it happens when you’re tired, ran out of fuel, feel dehydrated and generally in an all round bad state.

Here’s an interesting question then, why do people sometimes get cramp in their feet whilst they sleeping? How vigorous is your sleeping? Do you need to be waking at regular intervals to take on board electrolyte drinks? If you’re a triathlete, you may well have suffered from calves cramping during the swim, especially in open water. How dehydrated and fatigued can you really be during the early stages of a triathlon swim? That doesn’t make sense at all.

Geeks will love this…

I’m not pretending to give you the definitive answer to this question, but here is an opinion and some ideas. At this point let’s introduce the subject of ‘stretch receptors’ and the ‘stretch reflex’. You have receptors in your muscles and they detect how much and how quickly a muscle is stretching. If they believe a muscle to be stretching too much and too quickly, they trigger a contraction to protect the muscle. The best example of this (you will all have experienced the action of the stretch receptors), is running along happily and suddenly going over on your ankle. As you roll your ankle, the muscles on the outside of your lower leg contract and pull the foot back into position. You hobble for the next few steps, before realising that you got away with it and the ankle is still in one piece. What happened in that split second was not a conscious decision, you didn’t note that you had rolled your ankle or think about trying to correct it, the whole episode ‘just happened’, it was a contraction triggered by the stretch receptors.

What’s this got to do with cramp (or spasm for that matter)

When cycling, your hip flexors are in a shortened position (if your thigh is close to your stomach, hip flexors are shortened. The more aero, the more they’re shortened). Sometimes if i’ve been riding my bike for several hours, when i unclip, step off and stand upright, i get a ‘spasm’ in my hip flexors. I usually ‘crunch forwards’ immediately and then in goes. The likely cause of that small hip flexor spasm is the fact that the muscle has been working in a very short position for several hours. Over that time, the stretch receptors become accustomed to that shortened length. At the end of the ride I suddenly stand up vertical and the hip flexors lengthen dramatically. The stretch receptors are confused, causing a panic response which is a sudden sharp contraction (my little spasm) and it’s done to try and stop me lengthening the hip flexors too much or to quickly.

I’ve had this response before. My saddle height was too high which meant that I cycled with my toes pointing down slightly (posh term is planter felxtion, you can have that one for the next pub quiz). As my toes pointed down slightly, the calf was in a shortened position until the end of the bike ride. When I jumped off and started to run, the calf was suddenly lengthened and my stretch receptors (who had become comfortable with the shortened position during the bike) were alarmed by this sudden change, so reacted the only way they knew how, they initiated a sharp contraction (my calves cramped). It’s worth pointing out that most triathletes will cycle with a slightly ‘toes down’ position, so this problem is common.

Another example, a slightly shorter friend of mine, who is often referenced in this blog did the Ironman triathlon a few years ago. During the swim his calf kept ‘cramping’ and when he got out of the swim onto dry land, it cramped severely to the point where he could not walk! If fact, the cramp was so severe, he coudn’t run the marathon later in the race (to be fair, he probably wouldn’t have been able to run it under any circumstances). During open water swimming, the toes are pointed (it’s that plantar flextion thingy again), this means the calf is in a shortened and relaxed position. It’s probable that the stretch receptors become comfortable to that shortened position and perhaps become a little confused with this sorter length. When the calf is suddenly lengthened or sometimes when it isnt’t legnthened at all, this confusion in muscle length means that the stretch receptors trigger a sudden contraction. Sometimes the contraction is so strong, it can tear the calf muscle (or any other muscle), this is why severe ‘cramp’ as people often refer to it as, can lead to pain for several days.

How is this linked to the subject of lordosis?

In the original list of symptoms, we listed hip flexor cramps and quadricep cramps. Anterior tilt causes shortening of the hip flexors and the spasm I mentioned above, when I get off my bike is caused by lordosis / anterior tilt. In terms of quad cramps, one of the 4 quadricep muscles acts as a hip flexor. It’s called Rectus Femoris and if it’s tight, it tilts the pelvis forwards. In fact, there’s a strong research link between Rectus Femoris and back problems. If you have an enterior tilt of the pelvis (e.g. running after cycling) the Rectus Femoris muscle is in a shortened position. Running downhill encourages an anterior tilt of the pelvis and I’ve spoken to several people who in triathlon events, have suffered ‘cramp’ in the quads, in particular running downhill. It generally involves both legs completely locking.

Here’s the thing. All of the above scenarios are relatively common and advice tends to favour ‘salts and electrolytes’ to prevent the ‘cramp’. There is a real case of cramp or spasm caused by fatigue and dehydration, such as the 22 miles point in a marathon, but that’s not the simple answer. If you take the common example of cramping calves in open water swimming, there’s no way on earth that’s caused by fatigue or salt loss, all of the above can be explain by unnatural shortening of muscles and confusion of the muscle spindles and nervous system, resulting in a sudden contraction.

Okay, I haven’t touched on the stitch or breathing issues. I’d not anticipated on rambling so much. I could get 4 weeks out of this, it’s turning out better than expected. Next week we’ll talk about corrective exercises and ways to stop these problems. The following weeks, we’ll look specifically at breathing issues and the dreaded ‘stitch’.

If you suffer from calves cramping during swimming, hip spasms getting off the bike during long rides, quads cramping or any of the above, then reply and let us know with a single line. We can then tailor next weel’s exercises to the reponses and problems you have.

If you found this blog useful or interesting, we’d really appreciate a share, re-post or retweet on social media.

Until next week, stay relaxed.

About Marc:

Sports Science lecturer for 10 years at St Helens HE College.

2004 established The Endurance Coach LTD sports science and coaching business. Worked with British Cycling as physiology support 2008-2008. Previous Triathlon England Regional Academy Head Coach, North West.

In 2006 established Epic Events Management LTD. Now one of the largest event companies in the NW, organising a range of triathlon, swimming and cycling events. EPIC EVENTS also encompasses Montane Trail 26 and Petzl Night Runner events.

In 2010 established Montane Lakeland 50 & 100 LTD. This has now become the UKs leading ultra distance trail running event.

In 2010 established The Endurance Store triathlon, trail running and open water swimming store. Based in Appley Bridge, Wigan, we are the North West’s community store, organising and supporting local athletes and local events.

Check out the endurance store HERE