A blog post by our senior chartered physiotherapist, Abi Okell.

Chester half marathon is fast approaching, and many people are training for the London marathon, making the most of the lighter evenings. Unfortunately, overuse injuries are extremely common in runners and can have a big impact on training schedules. Often, these injuries are related to training error and are likely to occur in the first 6 months of running, upon return to running after injury or following an increase in distance or speed of running. Some of the more common running related injuries we see in clinic are outlined below:

 

Common Running Related Injuries
Achilles Tendinopathy is commonly linked with calf pain and/or tightness. It is characterised by pain and stiffness around the back of the ankle and heel. A sudden increase in mileage or hill running may cause inflammation of the Achilles tendon. Runners that tend to strike the ground with the fore-foot are also more likely to suffer Achilles tendinopathy due to increased load on the calf muscles.

Runner’s Knee (Patello-femoral pain) is irritation to the underside of the knee cap. It is often caused by an increase in running volume (mileage) or hill running, especially if a runner has weak quads or gluteal muscles. Pain will be felt around the knee cap and aggravated when the knee is bent for prolonged periods or when going down stairs or walking downhill.

Hamstring Strain is often linked with tightness or weakness in the hamstring muscles. It may be caused by over-stretching the leg forwards or pushing off the leg rapidly, such as during sprint training.  You may experience pain and tenderness over the back of thigh and potentially reduced power in the leg.

Plantar fasciitis affects the tendons and ligaments running between the heel and toes. Often you will notice a dull ache or tenderness along the sole of the foot or heel, which is usually worse first thing in the morning and aggravated by long periods of standing. Commonly, increasing running mileage too quickly can cause inflammation of these tendons and ligaments and small tears may develop in more severe cases.

 

Tips to prevent overuse injury
Running is a sport that continues to grow in popularity. As well as it’s many physical and psychological benefits, there is also a high risk of injury associated with running. Therefore, it is vital to know how to reduce the risk of developing an overuse injury…

1. Gradual changes in training are essential to try and avoid overuse injuries. This doesn’t just include mileage, but also pace, hill running and frequency of runs.
   Suddenly increasing mileage or adding in lots of hill running puts great stress on the muscles and joints in the legs. We need to remember that adaptations take time. Some experts suggest sticking to a 10% increase in pace or mileage when increasing training schedules. For example, if you run a total of 10 miles one week, aim to run a total of 11 miles the following week. However, if this is too much for you, try increasing weekly mileage by just 5%.

 

2. One goal! Having just one goal to focus on during each run allows you to focus your training. Are you aiming to increase pace, or are you aiming to reach a certain distance? Don’t try and increase both at the same time. Trying to achieve too much at the same time, or too much too soon, can often lead to injury.

 

3. Plan your training schedule on a weekly basis and make sure you include rest Do not be a weekend warrior! Muscles and joints need time to recover, in order to allow them to handle the training demands placed upon them. Therefore, you should schedule rest days between runs, and do strength training on days when you are not running.
   It is also a good idea to record how you feel after your runs to help you gauge your running threshold and allow you to spot patterns if you do suffer an injury. Allowing yourself to be flexible is also important. Don’t feel you have to stick to a set mileage, just because it is written in your schedule. If something doesn’t feel right or you are noticing pain during a run, do not push through it. Learn to recognise when you need to stop and adjust your plan.

 

4. Sshhh… Running with a quiet foot strike has been shown to increase running efficiency. Often this is due to a shortening of the stride length, which reduces impact forces, leading to a reduction in risk of injury.

 

5. Strength training that focusses around the hip can greatly improve stability of the whole lower limb. Research suggests a focussed strength and conditioning programme can reduce risk of injury and improve running economy.

 

6. Stretch at the end of your run The hamstring and calf muscles are commonly found to be tight in runners. Tightness in the calf muscles can lead to Achilles tendinopathy if not addressed. However, you should not do static stretches before a run, as this causes an immediate reduction in muscle power. Stretches should be performed at the end of a run as part of a cool down. The key muscles to stretch include the calf muscles, hamstrings, quads and gluteals.

 

If you do sustain an injury, it is vital that you reduce your mileage, reduce the pace of your runs, seek expert advice and start a treatment programme that includes focus on long term injury prevention.
To further advice or to make an appointment at CoActive Physio please call us on 07919 411845 or book online at www.coactivephysio.co.uk

 

References:

Aschwanden, C (2011). The Big 7 Body Breakdowns, How to avoid (and recover from) the most common running injuries. Runners World.

Burfoot, A (2010). The 10 Laws of Injury Prevention. Runners World.

Matava, M (2008). Running and Jogging Injuries, American Orthopaedic Society for Sports Medicine.

Nielsen, R et al. (2013). Classifying running-related injuries based upon etiology, with emphasis on volume and pace. International Journal of Sports Physical Therapy