Stiffness, Joint Instability, and the Strategies to Fix Them in Runners

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Is there anything more ubiquitous than runners feeling stiff? That palpable loss of movement or decreased tissue extensibility, often accompanied by pain and reduced running performance, is a quintessential byproduct of the impact forces of running.

Stiffness management is also so commonplace that it propels the sales of foam rollers, massage sticks, and stretch ropes. It also keeps massage therapists, physiotherapists, chiropractors, and yoga instructors busy.

So, if some stiffness is normal in runners, how much is too much? And what happens when the same running volume and intensity make one person objectively much stiffer than another? Worst of all, what if a typical amount of running that used to feel fine now makes you feel profoundly stiff, sore, and miserable?

It could be the aging process. It could be your stride losing its killer edge. Or it could be joint instability.

Stiffness From Aging and Stride Inefficiency

It is common to blame progressive stiffness in runners on aging. Age-related reductions in nervous system firing and metabolic function lead to slow reductions in top-end speed and endurance. But progressive worsening of joint and soft-tissue stiffness is not a hallmark of aging. In fact, tissue mobility is one of the few physiological characteristics that need not worsen with age. So if stiffness does worsen, and swiftly, we can’t simply blame aging.

Likewise, stride inefficiency plays a huge role in tissue integrity. As I often say, “How we run plays the biggest role in how we feel.”

For most runners, running technique is static for most of their mileage. While there may be cases of significant efficiency loss at the end of extreme running efforts, most runners walk before resorting to compensatory movements that can cause severe stiffness.

In fact, I argue for reverse causality, that progressive stiffness is more likely to change one’s stride. If certain tissues become dense and rigid, they won’t allow normal movement. Most runners who have experienced progressive stiffness will tell you that their symptoms preceded an altered gait.

Joint Instability Defined

That leaves another factor that could lead to stiffness: joint instability. Joint instability is when excessive movement occurs between two or more bones in a system.

According to his seminal work on the topic, Manohar Panjabi, an orthopedics professor emeritus, outlines three key components of joint stability (1):

• Passive system. The bones and ligaments of a joint create stability through their inherent hardness.
• Active system. The muscles that surround joints provide dynamic stability through muscle-tendon force. This system is capable of rapid, high-force control responses, but it requires accurate activation from the nervous system.
• Neural system. The nervous system is constantly evaluating the demands on the joint, determining the activation and movement patterns needed to maintain stability. It does so by integrating all the senses, including those of the passive system, and then commanding the active system.

Thus, we can say joint instability develops if any of these three systems is disrupted from its natural role.

The Stability Tripod

For maximum efficiency and highest performance, the above-described tripod of stability must work well in all three dimensions.

Normal healthy joints have a small amount of play — a bit of slide and glide between the bones that is accessory to the big motions. When any system in the stability tripod is deficient, it can create excessive joint motion or inefficient movement.

Imagine three people carrying a couch. If one person is weaker, that slack must be taken up by the other two. But even if they do, they often strain excessively and carry the load inefficiently, sometimes even dragging it.

Similarly, for a joint to be functionally stable, it requires sufficient stability from those three systems. A deficient system must be made up for by the others. If that’s not possible, negative, and often painful, compensations may occur.

This includes, paradoxically, increased stiffness.

How Joint Instability Creates Stiffness

Efficient motor performance is a dance: Muscles work in harmonious coordination, firing with the right force and timing to produce movement with minimal effort and strain. When one or more elements of the stability system are deficient, the dance can become a tug-of-war, leading to stiffness.

Stiffness may result from:

• Poor movement coordination, resulting in less motion that requires more energy
• Muscle overuse from muscles firing excessively or in competition with other muscles
• Irritated joint surfaces and tissues from inefficient movement

This all causes:

• An acute reduction in both top-end speed and endurance, and a sensation of being stiff, slow, and heavy
• Disproportionally high joint mobility and tissue extensibility loss following activity
• Increased joint pain following activity

Stiff Masters Runners: Is It Actually Instability?

When an orthopedic medical professional thinks about a typical “instability client,” we jump to an image of a younger, highly athletic female, often doing high-intensity activity featuring extreme movements and positions. We imagine a person with a hypermobile body type and deficient passive system stability.

But what about life-long endurance runners, often male, who are generally over 40 years old and active, but generally at low intensity and with modest movement patterns? They seem to be the opposite, don’t they?

Through my clinical and coaching experience with endurance athletes over more than two decades, I’ve found that older runners are among the biggest sufferers of orthopedic instability and the issues that come with it, including chronic pain, weakness, repetitive injury, and limited running volume and intensity.

Undiagnosed Instability

Instability in masters athletes often goes unrecognized for a couple of reasons.

First, most instability issues in older populations are isolated to a single joint, or a few joints: the spine, shoulders, or hips. Most orthopedists are taught about the Beighton Index, which is a measure of passive tissue hypermobility throughout the body used to screen for instability. Few masters clients will ever test highly under that index. Instead, their instability is more subtle and isolated to a few joints.

Secondly, this type of instability is shrouded in a murky mess of stiffness and soreness. This ranges from run-of-the-mill orthopedic tissue mobility loss to more focal, painful, and problematic stiffness that resembles injury. Many runners have stiff hips because they sit too much. But some have hip stiffness — often accompanied by increased pain and reduced performance — due to hip joint instability and compensatory movement patterns.

How do we know which is which? When should a runner consider their chronic stiffness the result of instability?

Four Signs of Clinical Instability in Older Populations

If you’re wondering if you have instability masked as something else, these are some possible signs.

1. Too Much Mobility

While masters athletes may not present as traditionally hypermobile, they are more mobile than they should be. Unless they perform specific lifelong activities that demand a full range of motion, like a consistent yoga practice, older runners with good mobility are likely to have passive system hypermobility.

What constitutes relative hypermobility? Here are a few “age-graded” mobility metrics that might suggest a masters runner has too much passive tissue mobility:

• Neck. Rotation greater than 80 degrees or side bending greater than 50 degrees
• Low back. Can easily get your fingers to the floor during a toe touch or a lumbar extension greater than 45 degrees (able to look to the ceiling or behind during a standing backbend)
• Hips. Flexion greater than 130 degrees
• Shoulders. Flexion or abduction greater than 180 degrees

2. Chronic Stiffness

As we’ve said, instability creates chronic stiffness through incorrect, excessive muscle contraction. That resultant excess motion can cause joint irritation.

3. Mobility Comes and Goes Quickly

A modest amount of mobility work that quickly creates mobility but is just as quickly lost is the real hallmark of failure in the active and neural systems. This generally means these systems are not controlling motion efficiently.

4. Mobility Is Highly Responsive to Stabilization Exercises

This is the most powerful sign, and also the best news. A signal of instability in masters populations is when targeted stability exercises result in immediate improvements in strength, joint mobility, and overall function. So while this may mean you have joint instability, it also means you can easily improve it by re-programming the neural system. Slow, controlled motions at the hip, for example, can create immediate and profound changes in hip mobility, as well as in running speed and endurance.

Three Strategies to Overcome Joint Instability

Once you have determined that joint instability is a factor in your stiffness, weakness, or performance decline, here are three strategies to tackle the issue.

1. Stop Over-Mobilizing

Most runners with chronic stiffness realize how temporary the results of their foam rolling and stretching routine are, but they might not know they could actually be making it worse by creating laxity.

Instead, perform a modest amount of mobility work — just enough to dispatch any focal stiffness — then follow with stability work.

2. Stabilize

Perform stabilization exercises targeting the joints and movement systems that are most salient to you. While this often requires the help of a professional, most runners can hedge their bets on:

• Lumbar spine core activation (Diagonal Chop exercise)
• Trunk and glute activation (Short and Long exercise)
• Three-dimensional hip stabilization (Joe’s Hip Six Pack exercises)

Test your motion, strength, and running speed, perform these stabilization exercises, and then test again. Major changes are a sign of instability and the importance of this stabilization work for you!

You’ll want to train stability consistently and frequently. For example, I recommend my clients with hip instability perform one set of one to three of the six-pack exercises linked above for activation, prior to any running activity, then all six exercises — two to four sets of each — as a focused workout, twice weekly. This provides the neural system activation for efficient movement while building up the muscular system for peak strength and endurance to meet the demands of running far and fast.

3. Move Efficiently

Lastly, hone your neural system by refining your stride:

• Consider running posture, including a balanced, neutral spine and hip hinge
• Think about propulsion, a vertical hip strategy maximizing hip and core utilization and minimizing landing stress

Consistently check in with mirrors, cameras, or your local running expert.

Don’t Give Up

If stiffness and tightness are stubborn to stretching, if hands-on work creates rapid changes that never seem to stick, and if parts of the body are too mobile, you might have joint instability. Excessive stiffness isn’t a normal byproduct of running or aging, so don’t accept it as the status quo. It’s time to get stable!

Call for Comments

• Do you suspect that you suffer from joint instability?
• Have you tried stabilizing joints? What was your experience?

Notes/References

1. Manohar M. Panjabi, “Clinical Spinal Instability and Low Back Pain,” Journal of Electromyography and Kinesiology 13 (2003): 371–379.

Stiffness, Joint Instability, and the Strategies to Fix Them in Runners by Joe Uhan.