The posterior chain: what it is and why it’s important for athletes

The posterior chain encompasses all the muscles on the back of the body, so everything from the trapezius down to the calves, and everything else in between. This includes some of the largest and most powerful muscles in the body, such as the glutes, which are essential for power generation during movements such as jumping, squatting, sprinting, and changing direction.

In our clinic, we often see the posterior chain being neglected, either because of the bias of muscles such as the quadriceps in certain exercises, or for vanity reasons because we don’t look at it in in the mirror the way we might the abdominals, pectorals or biceps!

As a result, many people we see have deficits in their posterior chain that can cause postural issues or compensatory movement patterns, which might materialise as issues in other body parts or joints such as the knees or back further down the line.

Why is the posterior chain important for triathletes?

As a triathlete, you have more considerations than an athlete who is only training for one discipline. Here, you’re looking to become skilful at three different forms of exercise, all of which come with their own risks and priority points for training and recovery. I want to therefore look at each exercise individually (swimming, cycling and running) and how you may tie these in together to improve your programming.

Swimming

One of the benefits of swimming as a cardiovascular exercise is that it involves no impact, which makes it popular with the elderly and those rehabilitating from an injury. Despite this, the repetitive motions involved can still cause some wear and tear over time. Glutes, hamstrings, calves, and lower and upper back muscles get very little involvement from swimming, causing the quads to take more load and the consequential imbalance leaving the lower body susceptible to injury.

Kicking, turns, and dives will all develop strong quads, but even more power can be generated by learning to ‘switch on’ the glutes and hamstrings. It’s not just the lower portion of the posterior chain that’s at risk, as rotator cuff tendinitis is the most common complaint we see among swimmers with more severe injuries occurring if untreated, such as tendinopathy and rotator cuff tears. (1)

Swimmer’s shoulder: what causes it and how to treat it

Cycling

As discussed, when there’s an imbalance between the quads and hamstrings strength and size, the knee becomes unstable, so you become at higher risk of biomechanical lower-limb injuries. Back injury can also be common among cyclists as cycling puts your lower back in a relatively vulnerable position due to your posture in the saddle in relation to your centre of gravity. This has been backed up by a study on Japanese triathletes that suggested that cycling is a major risk factor for low back pain in triathletes. (2)

How to prevent back pain caused by cycling

Running

Running, of the three, might be the one we associate with having the highest injury risk. Running has the most impact due to the loading of lower limb joints and it’s not unusual to hear runners complain of twists and strains. In elite, development squad and club triathletes, running accounts for a higher proportion of injuries than cycling, with injuries around the lower back being the second most common injury (3).

In addition to support provided by the back, improving hamstrings and gluteal strength enables more powerful legs which equates to faster running speed. It’s proven beneficial for runners to develop their posterior chain to keep ankle, knee, and hip joints healthy and reduce injury associated risks. Calves are also involved in many running related injuries, with weak muscles being a risk factor for strains (4). This highlights the importance of a strong posterior chain, from top to bottom, in running.

How to improve and strengthen the posterior chain

As you can see, there’s much to think about as a triathlete who is competitive at all three of the above! We’ve now touched on a few of the potential injuries that can arise from a weak posterior chain, from hamstring strain to ACL injuries and these injuries can take some time from onset for the athlete to be recovered enough to return to sport.

For example, acute hamstring strains can mean up to eight weeks away from sport with a period of relative rest, followed by stretching and graded return to activity (5) so prevention is much better than the cure! In clinic we refer to these preventative strategies as ‘pre-habilitation’ and our philosophy is always focussed on avoiding injury rather than be forced to rehabilitate an injury.

So, how can you prevent injury in the first place?

Even though you may not consider yourself a strength athlete, strengthening exercises are your best friend in developing the posterior chain. By building muscle tone in those areas and learning how to activate them through resistance training, you can develop your mind to muscle connection in those areas so that you are able to recruit them for other movements, such as swimming, cycling and running.

We suggest fitting at least two resistance training sessions into your week. These could be one with an upper body focus and one with a lower body focus or 2x full body sessions. For a full body session with priority on the posterior chain, we’d suggest something like this:

First session

Hip and rotator cuff warm up drills 15 minutes

Barbell hip thrust 3 x 8-12

Lat pulldown 3 x 12-15

Lying hamstring curl 3 x 12-15

Cable rope face pulls 3 x 12-15

Second session

Hip and rotator cuff warm up drills 15 minutes

Barbell squat 3 x 8-12

Pendlay row 3 x 8-12

Rear deltoid fly (dumbbell or machine) 3 x 12-15

Standing calf raise 3 x 10-15

The sessions above hit the trapezius muscles, rear deltoids, lats, hamstrings and glutes – among others! A session like this shouldn’t take much longer than 30 minutes, and you can even start with a lower volume approach (such as 2 working sets) to ease yourself in.

In the current climate when most people do not have access to a gym and are working out from home, these exercises can all be replicated with limited equipment. Resistance bands can be excellent for lat pulldowns, rows, face pulls and hamstring curls.

If you don’t have a barbell, change your squat for a goblet squat where any heavy object is held at chest height (elevate heels slightly if mobility and biomechanics do not allow for full depth). The same weight can be used for hip thrusts. Calves? Secure occlusion bands or tourniquets just under the knees and perform calf raises on a step with one hand keeping yourself balanced and a weight in the other.

In addition to this, you could weave in some mobility work to your routine. This can be done after your training session or just as part of your morning or night time routine. Try an easy sequence including gentle yoga movements such as cobra and downward dog to stretch the hamstrings and engage the core. This sort of low intensity exercise is great for getting blood flowing around the body, increasing range of motion, which can help recovery and reduce injury risk and even combatting stress!

Physio Matthew Taylor is the director and clinical lead at Sano Physiotherapy and has a particular interest in assessing and treating running-related injuries and headaches

References

1. Tuite, M., 2010. Imaging of Triathlon Injuries. Radiologic Clinics of North America, 48(6), pp.1125-1135.
2. Manninen, J. and Kallinen, M., 1996. Low back pain and other overuse injuries in a group of Japanese triathletes. British Journal of Sports Medicine, 30(2), pp.134-139.
3. Vleck, V. and Garbutt, G., 1998. Injury and Training Characteristics of Male Elite, Development Squad, and Club Triathletes. International Journal of Sports Medicine, 19(01), pp.38-42
4. Fields, K. and Rigby, M., 2016. Muscular Calf Injuries in Runners. Current Sports Medicine Reports, 15(5), pp.320-324.
5. BROWNING, K. and DONLEY, B., 2000. Evaluation and management of common running injuries. Cleveland Clinic Journal of Medicine, 67(7), pp.511-500.