I hope that you are having a relaxing few days off over the long weekend with your loved ones! Personally I got in a great session on the wind trainer followed by a quality run off the bike, after chilling out, re-fueling and a little bit of shopping, I thought that I would live up to my promise of writing up a blog on running injury prevention.
Running injury prevention is a huge topic, so I plan on breaking it down to what I call intrinsic (within variables) and extrinsic (external influences). Examples of intrinsic variables are muscle strength, core stability, ankle mobility etc, whereas external influences include factors such as training frequency, loads and intensities.
Running injury prevention is very, very close to my heart as personally and professionally as a Sports Physiotherapist I firmly believe in empowering my patients with knowledge about their body to help them manage their current concerns. Most importantly, it is critical to get to the cause of the concern by ensuring that they understand why the condition occurred in the first place. As a runner it is critical to understand how an injury occurred and most importantly to learn from the injury and get on top of the cause of the problem to minimise the risk of it reoccurring.
So let’s talk about some intrinsic links to running injury prevention!
By far the most common injuries that I see as a Sports Physiotherapist are plantar fasciitis, achilles tendinopathy (previously called tendonitis, I will explain why in a subsequent blog post), ITB friction syndrome and stress reactions/fractures. Now I am going to focus on intrinsic reasons that are linked with these injuries.
The number 1 problem I have with runners is that they love to run…. period… that is it! Nothing else… they get an amazing running high from running and commonly do not enjoy doing anything else. The problem I have with this is that all of us have internal or intrinsic weaknesses that we must work on in order to stay bio-mechanically efficient and reduce the risk of injury. The risk of injury obviously increases with the more km’s we do in our training each week, this is not rocket science, the longer you run the more steps you take so the risk of an overuse injury rises.
The problem with only running is that commonly the runner is not aware of specific components of their kinetic chain (lower limb function) not working as well as it could. Let’s go through some examples….
Common links are ankle mobility concerns and calf weakness that can be linked with achilles and plantar fascia overload. Another common concern in the foot is limitation in the big toe mobility (halux) due to bunion formation. If we make our way up to the knee the ITB is the devil when it comes to running, many runners have had symptoms here, including yours truly! The ITB can become a concern when it persistently rubs against the lateral epicondyle (bony ridge on the outside of the femur). The intrinsic variables that commonly lead to concerns here are linked in with core and gluteal weakness (lack of hip strength). Now I could talk about all of these injuries in a lot more detail… but the main thing to take on board is that to remedy or prevent these injuries internal weaknesses are commonly at play!
Another common link is runners knee, or maltracking of the kneecap. Commonly this is due to weakness in the quadriceps, particuarly the inside muscle called the VMO. Also weakness in the hips and lack of control in the foot can lead to the problem to.
So lets start putting this together… Runners need to be strong and have ROM in key areas. Additionally they develop tightness and stiffness in very predictable areas of the body from the repetition of running. So to help avoid a lot of these injuries many runners need to understand their shortfalls and ensure that they dedicate time on these to prevent injuries from coming. That is they must get to know their body well and more importantly know what weak areas they need to work on. Many runners generally have a very poor understanding of this.
Key areas to address with runners is tightness in the soleous (calf muscle), lateral (outer quad), ankle mobility, first toe mobility, quadricep strength, glute med and max strength and of course your core stability, not necessarily strength ( I can talk more about this topic in another blog).
Let me give you an example from yours truly! Personally I have a slightly weaker L glute max and quadricep, my right calf is slightly weaker and I have a stiff left ankle due to calf tightness. I address these issues by doing a targeted strength and conditioning program 2 x a week in addition to the usual running/triathlon training. To address the tightness I ensure that I spend 2 x a week on the foam roller doing self myofascial release on the key areas where I know I get a tight.
As a runner, it is critical that you have the same awareness… especially if you are prone to getting injuries and you take the option that most runners do… ”I’ll just rest it for 1-2 weeks then I’ll start running again”… sometimes this works as the reason for the injury was load related and backing off the load allows the injured structure to repair, however commonly the pain comes back, usually there is a clear reason behind this!
Lets get another point across! The longer/faster you run and the more km’s that you stack up in the training week the more time you need to spend on your weak links. That is if you start moving from running 40km’s/week to 60km’s a week to start training for a marathon, you load has gone up 50% in relation to distance. Commonly this is overlooked by runners! You need to spend more time doing the TLC on your weak links, the harder you train…. period!
Now this blog is not about plugging the running assessments, but I hope it gets the cogs ticking upstairs to understand the purpose behind my assessments. As part of the time spent with me, I will clearly highlight where your individual weaknesses are and show you how to remedy the concerns. So if you are a runner that keeps getting injured, or if you are de-conditioned and had some time off from running, my assessments are perfect for you!
Please feel free to ask me some questions….
P.S: This is me heading up Camels hump at the Mt Macedon 30km trail run last Sunday… on my way to my first win in 6 years… good day out for me!