Tips from Achilles

10th July 2018

The Great North Run boasts the world’s biggest half marathon, with participants taking on a gruelling 13.1 mile route from Newcastle city centre to South Shields.  It attracts people from around the world, from your elite athletes to the ‘weekend warrior’.  With it now fast approaching, we at Achilles Physio in Hexham want to do what we can to help you with your training.  Although we love to see you in our practice, we are happiest when our clients are pain-free and going about their usual activities that they enjoy most! 

If you have chosen to take part, may we first congratulate you on getting involved in such a great event! Running itself has countless health benefits and is relatively low cost when compared to other forms of exercise, making it a very popular activity.  On the downside, running is the source of many musculoskeletal injuries affecting many of our clientele.  One study has defined running-related injuries as “any physical complaint developed in relation with running activities and causes restriction in distance, speed, duration or frequency.” With that definition in mind, the incidence of running-related injuries has been reported as high as 84.9% of all runners.  Whilst that is a very high percentage, it is not our wish to deter you from participating in an activity with so many positive health benefits! What we will do is go through the most common types of running injuries, the risk factors for developing these injuries, and what you can do to bring the odds back in you favour.  

 

Running-related injuries are typically overuse injuries and consist of (but not limited to):

  • Patellofemoral pain syndrome – pain at the front of your knee around or underneath your kneecap.
  • Iliotibial band friction syndrome – pain in the side of your knee or over the bony prominence of your hip.
  • Medial tibial stress syndrome/shin splints – pain on the inside of your shin bone, usually closer to your ankle than your knee.  
  • Tendinopathies – Usually affecting:
    • Achilles tendon at the back of your ankle
    • Patellar tendon just below your kneecap
    • Hamstrings tendon at the back of your leg near your pelvis
    • Gluteal tendon at the side of your hip 
  • Plantar fasciopathy – pain underneath your foot/heel
  • Stress fractures in your leg, pelvis or back.  

 

Not every runner experiences these injuries, some are more predisposed to certain types of injuries than others due to individual differences.  Some of risk factors for running-related injuries include:

  • Older age – Alas! The familiar foe we call biology rears its ugly head.  Age causes our bodies to adapt and recover at a slower rate.  Oh, to be 20 again! 
  • High BMI – Studies have shown up to 6 times your body weight through your joints.  The lighter you are, the less ground reaction force your musculoskeletal system has to absorb.  
  • Prior injury – for many injuries, the best predictor of a future injury is a prior injury! 
  • Leg length discrepancy – biomechanically places more stress on some parts of your legs, pelvis and spine than others.
  • Abnormal alignment – an uneven load distribution puts you at greater risk of injury.  How many bridges do you see with crooked supports?
  • Foot posture – affects shock absorption and alignment of structures above.  
  • Training accumulation – Excessive load over time can cause structural failure.  A bridge designed for pedestrians may not be able to withstand trucks! 
  • Training surface – Running on non-forgiving surfaces like concrete and asphalt continuously may not be great for your joints, although there is limited evidence to back this up.  Best to be on the safe side and add in some off-road.  

 

These risk factors are by no means a contra-indication, but the risk factors you have the more likely you are to develop an injury.  Unfortunately, it can be very difficult and sometimes impossible to alter some of these risk factors.  Therefore, if they are present, my advice to you would be to proceed a little slower than usual with your training.  You may wish to use the FIT acronym here:

F = Frequency – Start off by training infrequently, then become more frequent over time.  

I = Intensity – Start off at a slower pace than what you may be able to run, then build up over time.  

T = Time – Start off training with a short duration, then slowly make your sessions longer.  

Unlike bridges, our bodies thrive by adapting to manageable loads, and the rate at which they adapt varies from individual to individual.  Have you heard of the saying “if you don’t use it, you lose it”? As with any form of activity, if you don’t run, your body adapts to not running.  The same can be said in reverse – if you run, your body adapts to running.  Our joints, muscles, tendons and bones respond to loading and become stronger, albeit at different rates.  Your body needs time to repair and regenerate after being tested which is why starting off your training slowly is a good idea, rather than attempting to run a half marathon from the outset.  This is not only true from a musculoskeletal perspective, but also a cardiovascular perspective.  If you are not accustomed to moderate to high intensity exercise and have any cardiovascular risk factors (eg. High cholesterol, high blood pressure, diabetes), it would be wise to seek medical advice prior to beginning your training.  

Our bodies have amazing shock absorption features and, when done under the right conditions, is good for our joints and bone health.  A common misconception is that running causes arthritis which has so far not been demonstrated in the best evidence available to us.  Despite our best efforts to prevent them, injuries still happen and are a part of life – it doesn’t always mean you have done something wrong.  So, if you are one of the unfortunate number to experience an injury with your training, or during the run itself, we would be only too happy to help you get back to doing what you do best! Please don’t hesitate to get in touch with us here at Achilles Physio for a consultation.  

Good luck, and remember – failing to prepare is preparing to fail!

 

 

Reference:

Bovens et al. (1989). “Occurance of running injuries in adults following a supervised training program”. Int J Sports Med.